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Short-term safety and operative outcomes of sacrospinous ligament fixation using the Mendit device
Alireza Hadizadeh1, Henry H Chill2, Angela Leffelman3
1Division of Urogynecology, University of Chicago Pritzker School of Medicine (Hadizadeh, Chill, Leffelman, Paya-Ten, Burgos, Crawford, Chang and Rostaminia), NorthShore University HealthSystem, Skokie, Illinois; NorthShore University HealthSystem Research Institute (Hadizadeh), Evanston, Illinois.
Study Objective:
To evaluate short-term safety and operative outcomes of sacrospinous ligament fixation (SSLF) performed using a minimally invasive anchoring device (Mendit) for apical repair.
Design:
Retrospective single-arm cohort study.
Setting:
Tertiary care university-affiliated urogynecology centre.
Patients:
Women ≥21 years undergoing transvaginal SSLF with the Mendit anchoring system between January 2023 and June 2025 (n = 84).
Interventions:
Apical prolapse repair using anchoring device for SSLF performed via either conventional vaginal dissection or percutaneous incisionless technique, with or without concomitant procedures.
Measurements And Main Results:
Mean age was 69.2 ± 11.1 years and mean BMI 26.7 ± 5.6 kg/m². Most patients had advanced prolapse (mean stage 3.6 ± 0.8). Bilateral fixation was performed in 67.9% of cases and concomitant procedures were common, including mid-urethral sling placement (40.9%). Mean operative time for the full procedure was 38.7 ± 14.9 minutes and estimated blood loss was 31.7 ± 42.2 mL. No intraoperative major organ injuries or transfusions occurred. Device malfunction occurred in <1% without clinical consequence. No serious postoperative complications (Clavien-Dindo >III) were observed. The most common adverse event was transient urinary retention (23.2%), resolving without intervention. Thirty-day reoperation occurred in 3.6% of patients. One urinary tract infection (1.2%) occurred. No early prolapse recurrences were identified. The percutaneous approach demonstrated shorter operative time and lower blood loss compared with conventional dissection.
Conclusion:
Device-assisted sacrospinous ligament fixation demonstrates a favourable short-term safety profile with low complication and reoperation rates. The percutaneous technique may reduce operative time and tissue dissection while maintaining clinical safety. This approach represents a promising minimally invasive native-tissue alternative for apical prolapse repair.
