Related Experiment Video
Updated: Apr 18, 2026
Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
Published on: September 13, 2022
Abdominal mesh sacrocolpopexy without promontory fixation: initial results of the peritoneocolpopexy technique
Dominic Lee1, Philippe E Zimmern1
1Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas.
Purpose:
We present our experience and early outcomes using a new technique for mesh anchorage during open sacrocolpopexy called peritoneocolpopexy.
Materials And Methods:
A prospective review of patients from an institutional review board approved sacrocolpopexy database who underwent mesh peritoneocolpopexy was performed. Data included complications, validated questionnaires, pelvic organ prolapse quantification examination and associated outcomes. After placement of a Marlex® mesh anteriorly and posteriorly to the vaginal apex, the tail of the mesh is positioned in a peritoneal groove extending toward the promontory. The mesh is secured to surrounding tissues (peritoneum and fat underneath) with 2 running 2-zero V-Loc™ 180 (unidirectional barbed delayed absorbable) sutures placed on either side of the mesh tail well below the promontory.
Results:
Fourteen patients were identified from our prospective database. Mean age and followup were 60.5 years (range 28 to 82) and 19.6 months (range 7 to 38.3), respectively. Mean preoperative C-point was -2.7 (range 2 to -10) compared to -9.5 (range -8 to -12) postoperatively (p <0.003). No prolapse recurrence was noted. Mean operative time, blood loss and postoperative hospital stay were 238 minutes (range 160 to 300), 129 ml (range 20 to 900) and 3 days (range 1 to 6), respectively. Functional outcome improvement was statistically significant for total UDI-6-6 to 3 (p = 0.04), quality of life-4.1 to 2.1 (p <0.27) and IIQ-7-6 to 2 (p = 0.3), respectively.
Conclusions:
Peritoneocolpopexy performed reliably to correct symptomatic pelvic organ prolapse with satisfactory anatomical outcomes for apical support. Longer term followup is required to fully assess durability of repair.
Insights
Peritoneocolpopexy offers a reliable method for correcting pelvic organ prolapse, showing significant anatomical improvements and no recurrence in early outcomes. Further studies are needed to confirm long-term durability.
Area of Science:
- Urogynecology
- Pelvic Floor Surgery
- Surgical Innovation
Background:
- Pelvic organ prolapse (POP) significantly impacts women's quality of life.
- Traditional surgical techniques for POP can have limitations in achieving durable apical support.
- Mesh anchorage is crucial for successful open sacrocolpopexy.
Purpose of the Study:
- To evaluate the early outcomes and feasibility of a novel mesh anchorage technique, peritoneocolpopexy, for open sacrocolpopexy.
- To assess the anatomical and functional results of this new surgical approach.
Main Methods:
- A prospective review was conducted on patients undergoing mesh peritoneocolpopexy for POP.
- Data collected included operative details, complications, validated questionnaires, and Pelvic Organ Prolapse Quantification (POP-Q) examination.
- The technique involves securing Marlex® mesh to the vaginal apex using V-Loc™ sutures within a peritoneal groove.
Main Results:
- Fourteen patients were analyzed with a mean follow-up of 19.6 months.
- Significant improvement in POP-Q C-point from -2.7 to -9.5 (p <0.003) was observed, indicating successful apical suspension.
- No prolapse recurrence was noted, and functional outcome scores showed statistically significant improvements.
Conclusions:
- Peritoneocolpopexy is a reliable technique for correcting symptomatic pelvic organ prolapse, providing satisfactory anatomical apical support.
- The early results suggest good efficacy and patient-reported outcomes.
- Longer-term follow-up is necessary to fully establish the durability of this mesh anchorage method.
