Summary 129 SUMMARY Herein, we aimed to explore the potential benefit of three novel therapies for prolapse and/or urinary incontinence. Both conditions are common in women, negatively affect their quality of life, and the current treatment options to which the novel treatments would be an alternative, have their shortcomings. We performed two assessor-blinded randomized controlled trials comparing vaginal laser therapy to PFE, the current conservative standard of care for both mild to moderate POP and mild to moderate SUI. Forty-six and sixty women respectively, were included in these trials. The primary outcome was patient-reported subjective improvement in symptoms. For both conditions, vaginal laser therapy and PFE improved symptoms to a similar extent on the short term. No adverse events were reported in either arms up to two years after randomization. However, by that time, more than half of the participants requested for additional, yet alternative therapy. In view of the significant cost typically associated to laser therapy, these observations question the added value of laser to the current portfolio of conservative treatments. In view of assessing the potential of a surgical treatment of urge and mixed incontinence in the presence of prolapse, we systematically reviewed the literature on the efficacy and safety of cervicosacropexy and vaginosacropexy. Data collection, risk of bias, and certainty of evidence were assessed using the standard Cochrane methods. The included studies (1 RCT and 8 case series) showed a moderate-to-high risk of bias and low certainty of evidence. Therefore, we concluded that this intervention first needs additional robust and convincing data before its wider implementation in clinical practice. In our unit, laparoscopic sacrocolpopexy has a pivotal role in the surgical treatment for symptomatic stage ≥2 cervical or vault prolapse. For this operation, we use a synthetic mesh, contributing to the longevity of the results, yet putting the patient at risk for graft related complications. To decrease the latter, meshes have been made lighter. In a first single-center study we compared the outcomes of two consecutive prospective cohorts of patients undergoing laparoscopic sacrocolpopexy, using either heavier-weight-polypropylene (n=101) or lightweight polypropylene (n=238) mesh at similar duration of follow-up. At a median of 8 years after the index procedure, symptomatic graft-related complications were six times more likely for heavier weight mesh and five times more likely to undergo a reintervention for that. Conversely, the vast majority of patients who underwent laparoscopic sacrocolpopexy are (much) improved (PGIC-score 4 or higher), regardless of the type of implant used. Recurrence rates at the vault were low and not different between groups, hence reinterventions for recurrent apical prolapse were scarce. In the rare event of recurrence, one may contemplate to offer a “redo-“ LSCP. In a single-center 4:1 matched case-control study we compared 39 consecutive women undergoing a redo LSCP with
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