A Meshless Practical Laparoscopic Sacrohysteropexy Modification and Long-term Outcomes

Abstract

Study ObjectiveTo describe a new modification of laparoscopic sacrohysteropexy without using a mesh and report the 3-year outcomes. DesignA prospective cohort study. SettingMinimally Invasive Gynecology Unit, Bursa Uludag University Hospital, Turkey. PatientsWomen who were diagnosed with ≥ stage 2 uterine prolapse. InterventionsA laparoscopic sacrohysteropexy modification using a polyester fiber suture instead of a standard polypropylene mesh. Measurements and Main ResultsThe primary outcome was the anatomic success of the repair, with success defined as objective parameters using the pelvic organ prolapse quantification system. The secondary outcomes were subjective outcomes, which were assessed using the quality-of-life scales. Forty-seven women who underwent the procedure were followed up for a minimum of 3 years. Forty-four of the 47 patients had stage 0 or 1 prolapse at the end of the second year, according to the primary outcomes. The anatomic success rate was 93.6%. In the secondary outcomes, 2 patients were not satisfied with their pelvic floor after the second year. The subjective cure rate was 95.7%. There was a statistically significant improvement in both pelvic organ prolapse quantification and quality-of-life scores in the third postoperative year. The mean operating time was 84.6 minutes, and the mean estimated blood loss was 21.3 mL. There were no bladder or bowel complications in the perioperative or postoperative period. ConclusionLaparoscopic sacrohysteropexy can be performed safely with this meshless modification in uterine prolapse as an alternative.