We have published [1] a retrospective monocentric single operator series of all laparoscopic sacrocolpopexies performed for genital prolapse, according to the double mesh technique described in this book at the unit of Gynecology of the University Hospital of Caen between January 1993 and December 2002. We excluded patients who had laparoscopic mesh suspension for Masters and Allen Syndrome [2] as well as those who had a conversion to laparotomy for any reason. Patients were found through the French hospital discharge data base, the Programme of Medicalisation of Information System (PMSI) and all the hospital files as well as the operative and consultation reports were reviewed by two independent investigators.

The procedures have all been performed by me using the same surgical technique previously described for first 44 women [3, 4]. Laparoscopic Burch colposuspension [5] was almost systematically performed between 1993 and 2000. Later, TVT was used but only in case of objective stress urinary incontinence (SUI).

The study has been conducted in three steps. First step was the analysis of the medical files in order to gather pre, per and post operative data like BMI, previous history, staging of the POP according to the International Continence Society (ICS): Pelvic Organ Prolapse Quantification POP-Q [6], SUI, surgical report, associated procedures (hysterectomy, ovariectomy, etc.), complications. Second step was an observational descriptive evaluation. All the patients were directly contacted by phone first (to get their agreement participate, confirmed later by signature) and by mail (questionnaire). Quality of life (QoL) has been evaluated with the French validated short version of Pelvic Floor Distress Inventory 20 (PDFI 20) with the three sub groups of questions: Urinary Distress Inventory (UDI 6), Colo-Rectal and Anal Distress Inventory (CRADI 8) and Pelvic Organ Prolaps Distress Inventory (POPDI 6). Pelvic Floor Impact Questionnaire (PFIQ 7) has also been completed. This questionnaire has also three sub groups: Urinary Impact Questionnaire (UIQ 7), Colo-Rectal and Anal Impact Questionnaire (CRAIQ 7) et Pelvic Organ Prolaps Impact Questionnaire (POPIQ 7) [7, 8]. Last step was a clinical assessment of the anatomy. This examination, performed by an independent gynecologist (EM), was standardized to assess the anatomical defects according to ICS POP-Q. For the purpose of statistical data analysis, qualitative variables were described as frequency and percentages and quantitative ones as mean (ranges). To analyse risk factors for relapse we used chi-squares (or Fisher exact test) or t-test (or Mann-Whitney tests), as appropriate. The level of significance was set to 0.05 for these main analyses (bi sided tests). Analyses were carried out at the “Unité de Biostatistique et Recherche Clinique” (Caen University Hospital) using SPPS software vs 19.