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Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
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A Meshless Practical Laparoscopic Sacrohysteropexy Modification and Long-term Outcomes
Adnan Orhan1, Kemal Ozerkan1, Isil Kasapoglu1
1Department of Obstetrics and Gynecology, Urogynecology, and Minimally Invasive Gynecology Unit (Drs. Orhan, Ozerkan, Kasapoglu, Aslan, and Uncu).
Journal of Minimally Invasive Gynecology
|March 6, 2020
Summary
This study presents a meshless laparoscopic sacrohysteropexy for uterine prolapse, achieving high anatomic (93.6%) and subjective (95.7%) success rates over 3 years with no major complications.
Area of Science:
- Minimally Invasive Gynecology
- Pelvic Floor Surgery
- Urogynecology
Background:
- Uterine prolapse affects many women, often requiring surgical intervention.
- Traditional laparoscopic sacrohysteropexy frequently utilizes polypropylene mesh.
- Mesh use can be associated with complications, necessitating alternative approaches.
Purpose of the Study:
- To describe a novel meshless modification of laparoscopic sacrohysteropexy.
- To evaluate the 3-year outcomes of this modified procedure for uterine prolapse repair.
Main Methods:
- A prospective cohort study involving women with stage 2 or higher uterine prolapse.
- Laparoscopic sacrohysteropexy was performed using a polyester fiber suture instead of mesh.
- Outcomes assessed included anatomic success (Pelvic Organ Prolapse Quantification) and subjective quality of life over 3 years.
Main Results:
- Anatomic success rate was 93.6% (44/47 patients achieving stage 0 or 1 prolapse by year 2).
- Subjective cure rate was 95.7%, with significant improvements in quality-of-life scores.
- Mean operative time was 84.6 minutes; mean blood loss was 21.3 mL, with no perioperative bladder or bowel complications.
Conclusions:
- Meshless laparoscopic sacrohysteropexy is a safe and effective alternative for uterine prolapse treatment.
- This modification offers comparable success rates to mesh-based procedures.
- Further research can explore long-term efficacy and patient-reported outcomes.
