Vesicovaginal Adhesion as an Independent Factor of Postoperative Recurrence after Laparoscopic Sacrocolpopexy

Laparoscopic sacrocolpopexy (LSC), which is known for its low recurrence rate, is considered the gold standard for treating pelvic organ prolapse (POP). However, in some cases, prolapse recurrence occurs even after LSC, and its cause remains unclear. Thus, the current study aimed to investigate the factors correlated with POP that contribute to postoperative prolapse recurrence.

The study enrolled 95 patients who underwent LSC at our hospital between June 2016 and December 2023. The Pearson's Chi-square test, multiple logistic regression analysis, and Cox proportional hazards analysis were performed to determine the independent factors contributing to prolapse recurrence.

Based on the Pearson's Chi-square test, age (≥74 or <74 years), pelvic organ prolapse staging system (4 or ≤3), and the presence of vesicovaginal adhesion were significantly correlated with prolapse recurrence (all P < 0.05). Among the preoperative and intraoperative factors, only the presence of vesicovaginal adhesion was a significant factor in the univariate and multivariate logistic regression analyses (P = 0.0034). In addition, only the presence of vesicovaginal adhesion was an independent factor of shorter time to prolapse recurrence in the multivariate Cox proportional hazards model (hazard ratio: 17.46, 95% confidence interval: 1.69-180.15, P = 0.0163).

Vesicovaginal adhesion can be an independent factor of postoperative recurrence after LSC. In patients with POP undergoing LSC, particularly those with vesicovaginal adhesion, the anterior mesh may need to be fixed firmly.