McCall culdoplasty vs. vaginally assisted laparoscopic sacrocolpopexy in the treatment of advanced uterine prolapse: A randomized controlled study

Abstract

Objective: The primary aim of this study was to compare the anatomic outcomes of vaginally assisted laparoscopic sacrocolpopexy (VALS) with those of McCall culdoplasty (McCC) in patients undergoing concurrent vaginal hysterectomy. Materials and methods: This randomized controlled study presents the outcomes of 68 patients who underwent hysterectomy and vaginal suspension for apical prolapse ≥ Stage III according to the Pelvic Organ Prolapse Quantification (POP-Q) system between October 2017 and December 2020. Among these patients, 33 underwent VALS and 35 underwent McCC. Clinical features, surgical data, concomitant surgical procedures, postoperative complications, and recurrence rates were assessed. Before and after one year of surgery, the short form of the Pelvic Floor Impact Questionnaire and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire were used to evaluate subjective symptoms. Patient Global Impression of Improvement Questionnaire was used to assess patient satisfaction. Results: The mean follow-up durations were 25.5 ± 7.63 months and 25.6 ± 5.96 months in the VALS and McCC groups, respectively. Prolapse recurrence occurred in 3 (9.1%) women in the VALS group versus 12 (34.3%) women in the McCC group (p = 0.031). Conclusion: The McCC operation was associated with a shorter operation time, whereas the VALS operation had a significantly higher objective success rate. Based on this study, it may be concluded that McCC is not an effective procedure for advanced uterine prolapse.

Keywords

• Apical prolapse
• McCall culdoplasty
• Pelvic organ prolapse
• Vaginally assisted laparoscopic sacrocolopopexy