Pectopexy for Pelvic Organ Prolapse: A Scoping Review

Area of Science:

• Gynecology
• Urogynecology
• Surgical Innovation

Background:

• Apical pelvic organ prolapse (POP) affects many women, necessitating effective surgical interventions.
• Pectopexy is an emerging surgical technique that anchors prolapsed structures to the iliopectineal ligament.
• Evidence on pectopexy's efficacy and safety is still developing.

Purpose of the Study:

• To systematically review and map the existing evidence on pectopexy for apical pelvic organ prolapse.
• To analyze study characteristics, surgical techniques, and reported outcomes of pectopexy.
• To identify gaps in the current literature regarding pectopexy.

Main Methods:

• Systematic literature search across multiple databases (PubMed, Scopus, CENTRAL, etc.) and citation searches.
• Inclusion of randomized controlled trials (RCTs), cohort studies, and descriptive studies of pectopexy for POP-Q stage ≥2.
• Independent data extraction and descriptive synthesis of findings by two reviewers.

Main Results:

• Thirty studies (2715 women) were included, predominantly descriptive studies from Asia, utilizing laparoscopic pectopexy with mesh.
• Commonly reported outcomes included operative time, blood loss, prolapse recurrence, stress urinary incontinence, and fixation material complications.
• Patient-reported outcome measures (PROMs) and subjective outcomes were infrequently reported.

Conclusions:

• Pectopexy procedures and outcomes are highly heterogeneous.
• Current evidence is limited, particularly from high-quality RCTs and low-resource settings.
• There is a need for more standardized reporting of subjective outcomes and PROMs in pectopexy research.