V267: Total Utilization of Retroperitoneum For Colpopexy (TURC) For The Treatment of Advanced Uterovaginal and Vault Prolapse: Midterm Results
VideoIntroduction and Objectives
We report midterm outcomes of larger series of the patients underwent TURC. Total Utilization of Retroperitoneum for Colpopexy (TURC) has been reported as a new technique with minimal morbidity and less operative time compared to abdominal intraperitoneal sacrocolpopexy in the treatment of advanced prolapses.
58 consecutive patients with advanced uterovaginal/vaginal cuff prolapsed (grades III – IV according to POP-Q system) underwent TURC between July 2007 and September 2012. The steps of the procedure include: 1.Mobilization and medialization of right pelvic parietal peritoneum through pfannenstiel incision, 2.Visualization of promontorium and fixation of mesh to anterior longitudinal ligament 3.Lateralization of right ureter to prevent kinking and compression,4.Separation of peritoneum from the bladder wall,5.Dissection of anterior and lateral vaginal from the bladder, 6.Fixation of mesh to anterolateral vaginal wall. Pre-operative findings were compared with postoperative values at the last follow-up using the Wilcoxon sign test.
Mean age of patients was 53,4 (29-78) years. Mean operation time was 41,7 (25-90) minutes. All patients were discharged from the hospital within 24 hours. Urethral catheter was removed before the discharge from the hospital except one who had bladder perforation. The catheter was removed on 6th day in this patient without any subsequent complications.With a median follow up of 24 months,96.5% (56/58) of patients were objectively cured, and subjective cure rate was 93.1% (54/58). All patients had significant improvement in the PFDI-SF20,PFIQ-7 scores and POP-Q measurements at the last follow-up. Post-operative GIS complications were not encountered in any case.
Our midterm results confirm that TURC is a safe, feasible and effective technique and one-day procedure with no GIS complications and less comorbidity compared to intraperitoneal sacrocolpopexy.