Does Round-Ligament-Based Non-Mesh Pectopexy Provide Durable and Effective Apical Support After Total Laparoscopic...

Area of Science:

• Urogynecology and Pelvic Reconstructive Surgery
• Minimally Invasive Gynecological Surgery
• Female Pelvic Floor Disorders

Background:

• Uterine prolapse significantly impacts women's quality of life.
• Traditional surgical repairs often involve synthetic mesh, carrying potential risks.
• Effective apical support is crucial for successful prolapse surgery.

Purpose of the Study:

• To evaluate the anatomical and clinical outcomes of a novel, mesh-free cerclage pectopexy technique.
• To assess the efficacy of using the round ligament for apical support after total laparoscopic hysterectomy.
• To determine the safety and feasibility of this technique in women with stage II uterine prolapse.

Main Methods:

• Retrospective observational study of 120 women with stage II uterine prolapse.
• Total laparoscopic hysterectomy followed by laparoscopic non-mesh pectopexy using round ligaments.
• Pelvic Organ Prolapse Quantification (POP-Q) system used for assessment at multiple time points.

Main Results:

• 95% anatomical success rate at 12 months, defined as apical stage ≤ I.
• Significant improvement in POP-Q measurements and preservation of total vaginal length.
• Favorable functional outcomes, low postoperative pain, and no mesh-related complications.

Conclusions:

• Round-ligament-based non-mesh cerclage pectopexy offers reliable apical support with low morbidity.
• This technique effectively avoids synthetic mesh while achieving good short-term outcomes.
• Further long-term comparative studies are needed to establish its full potential.