Laparoscopic Pectopexy: A Safe and Effective New Approach for Repair of Pelvic Organ Prolapse

Abstract

<h3>Study Objective</h3> To assess the feasibility, safety and effectiveness of laparoscopic pectopexy for repair of pelvic organ prolapse. <h3>Design</h3> prospective study. <h3>Setting</h3> Jaipur Doorbeen Hospital in Jaipur, Rajasthan. <h3>Patients or Participants</h3> 108 women of POP-Q stage ≥II who underwent laparoscopic pectopexy between January 2017 to January 2019 were included. <h3>Interventions</h3> All patients underwent laparoscopic mesh fixation to bilateral pectineal ligament with Moschcowitz repair with pelvic floor repair and vaginal rectocele repair if any. <h3>Measurements and Main Results</h3> among 108 patients, mean age was 48.29 + 14.82years and mean BMI was 24.10 + 3.19kg/m2. Out of 108 cases 24.07% of stage II, 71.30% of stage III and 4.63% of stage IV. Maximum cases were under stage III (71.30%). There were no major intra operative and postoperative complications. Follow up was done at one week, one month,3rd month, 6th month and one to 3 years. On follow up till January 2022, we could contact 88 women, 20 women lost to follow up. out of 108 cases only 5(4.62%) patients show recurrence of prolapse. Out of 5 cases,2 cases show first degree cystocele, 1 case show first degree rectocele, 1 case shows first degree UV decent and 1 case was complete relapse showing second degree prolapse.no mesh erosion seen in 3year follow up of 88 cases. Results are promising with 95.37% all over success rate. <h3>Conclusion</h3> The laparoscopic pectopexy is a good alternative to the laparoscopic Sacropexy. It is equally effective and shows no de novo SUI, defecation disorders, backache or neuralgia in the long-term follow-up.