タグ: LSC

Laparoscopic Sacrocolpopexy (LSC): Now Possible with Just a 2-Night Hospital Stay

3月 29th, 2025

Pelvic organ prolapse (POP) surgery is becoming more accessible than ever

For a long time, laparoscopic sacrocolpopexy (LSC)—a commonly performed surgery for pelvic organ prolapse—required a hospital stay of about one week. This extended hospitalization was often a barrier for many women balancing busy lives and family responsibilities.

However, things are changing.

LSC in Just 2 Nights, 3 Days

Today, some medical institutions in Japan now offer LSC with a 2-night, 3-day hospital stay, thanks to medical advancements and streamlined surgical care.

Hospitals currently providing short-stay LSC include:

• Kameda Medical Center, Department of Female Urology

• Awa Regional Medical Center

• Yotsuya Medical Cube

Here’s what the typical schedule looks like:

• Kameda and Awa Center:

Day 1 – Admission

Day 2 – Surgery, Catheter removal

Day 3 – Discharge

• Yotsuya Medical Cube:

Day 1 – Admission & Surgery

Day 2 – Catheter removal

Day 3 – Discharge

Why Not Shorter, Like Day Surgery?

Technically, it is possible to do LSC as a 1-night or even same-day procedure.

However, due to the need for pre-op orientation, testing, nursing assessments, and administrative procedures, shorter hospital stays can be difficult to implement in large hospital systems.

Safer Anesthesia and Faster Recovery

The shift toward shorter stays has been driven by safer general anesthesia and the use of laparoscopic (minimally invasive) techniques.

For example, laparoscopic inguinal hernia surgeries are now often performed as outpatient procedures, with patients going home the same day.

LSC, being similar in nature, is also heading in this direction.

Moreover, many institutions are now introducing ERAS (Enhanced Recovery After Surgery) protocols, which focus on reducing post-operative discomfort and helping patients recover faster and more comfortably.

Could Same-Day LSC Be the Future?

With ongoing medical innovation and thoughtful perioperative management, same-day discharge after LSC may one day become a reality.

This is exciting news for women who may have postponed surgery due to time or scheduling concerns.

Bringing Surgery Closer to Everyday Life

The traditional view that “surgery means long hospital stays and a lot of hassle” is being rewritten.

Women juggling work, family, and personal time no longer need to give up on treatment for pelvic organ prolapse.

We’re entering a new era where surgery is more accessible, efficient, and patient-centered.

If you’ve been putting off care because “there’s just no time,” you might be surprised to find that treatment is now much more convenient.

#PelvicOrganProlapse

#LSC

#Sacrocolpopexy

#MinimallyInvasiveSurgery

#FemaleUrology

#Urogynecology
Discomfort Similar to Urinary Leakage After Surgery for Pelvic Organ Prolapse

12月 14th, 2024

This type of discomfort is also seen in some patients after hip surgery. While the hip joint and pelvic organ prolapse may seem unrelated, both conditions share a common factor: issues with the obturator internus, a key muscle of the pelvic floor.

When discussing the pelvic floor, many tend to focus solely on the levator ani. However, muscles like the obturator internus and piriformis, which are external rotators of the hip joint, are also integral components of the pelvic floor.

It is well-known that hip joint dysfunction can lead to obturator internus impairment, causing perineal discomfort or urinary incontinence. But why does a dysfunction in the obturator internus result in perineal discomfort?

The reason lies in the anatomical relationship: the pudendal nerve runs along the posterior surface of the obturator internus. Excessive stimulation or tension in the obturator internus can be perceived by the pudendal nerve as abnormalities within its sensory domain.

The pudendal nerve has superior, middle, and inferior branches that innervate different parts of the perineum. Depending on the branch affected, symptoms may appear in the clitoris and urethra (superior branch), the vagina (middle branch), or the anus (inferior branch).

To alleviate excessive stimulation of the obturator internus, the primary goal is to reduce tension. Treatment options may include rehabilitation, medications (e.g., herbal remedies, neuropathic pain relievers, muscle relaxants), magnetic stimulation therapy, hydrorelease, or shockwave therapy. Selecting appropriate therapies that target the muscle can help address the symptoms effectively.
Pelvic organ prolapse, LSC

11月 5th, 2024

Today, I performed a laparoscopic surgery at Kameda General Hospital to treat pelvic organ prolapse while preserving the uterus. The surgery took just under three hours, with minimal blood loss. The patient was able to walk and eat three hours after surgery, and she will be discharged tomorrow.

The patient, a woman in her 60s from Tokyo, was initially unable to effectively engage her pelvic floor muscles. She strongly desired surgery to “quickly correct the problem.”

However, if a patient cannot perform proper pelvic floor muscle contractions (which protect the pelvic floor), there is a high risk of recurrence of pelvic organ prolapse, even after corrective surgery. Therefore, we prepared her with about three months of pelvic floor rehabilitation to train her body before surgery.

During the surgery, we found signs of a past history of endometriosis, with multiple adhesions in the pelvic cavity. When I informed her husband afterward, he recalled that she had often complained of abdominal pain.
pelvic organ prolapse and pelvic pain syndrome

10月 23rd, 2024

A woman in her 70s with pelvic organ prolapse (cystocele and uterine prolapse) had preoperative pain in the perineal and hip joints.

She had tenderness in both obturator internus muscles, and after starting rehabilitation, her hip pain disappeared, leading to the cancellation of her hip surgery (although surgery might still be recommended due to existing deformities). It’s challenging to determine which pain is related to “hip pain,” “perineal pain,” or “pelvic organ prolapse.”

We performed a hysterectomy (preserving the descending branch of the uterine artery and the vaginal artery), and placed a mesh between the bladder and vagina, achieving a neat result. Postoperatively, she was able to get out of bed after three hours and did not have a urethral catheter, so she was able to urinate on her own in the restroom. She was discharged the next day.

This patient was also being seen by a gynecologist. The gynecologist said, “Abe-chan, you’ve been focusing on the obturator internus muscles lately, right? Seems like she no longer needs hip surgery.”

The “importance of obturator internus muscle rehabilitation” is gradually gaining wider recognition.

タグ: LSC

Laparoscopic Sacrocolpopexy (LSC): Now Possible with Just a 2-Night Hospital Stay

Discomfort Similar to Urinary Leakage After Surgery for Pelvic Organ Prolapse

Pelvic organ prolapse, LSC

pelvic organ prolapse and pelvic pain syndrome