Laparoscopic Pectopexy: A Prospective, Randomized, Comparative Clinical Trial of Standard Laparoscopic Sacral Colpocervicopexy with the New Laparoscopic Pectopexy—Postoperative Results and Intermediate-Term Follow-Up in a Pilot Study

Noé, Günter K.; Schiermeier, Sven; Alkatout, İbrahim; Anapolski, Michael

doi:10.1089/end.2014.0413

Cited by 86 publications

(88 citation statements)

References 23 publications

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“…Biler et al, in the study about abdominal sacropexy, LS and pectopexy, found no occurrences of de novo apical prolapse at 6 months follow‐up. In studies regarding pectopexy, we found one (2.3%) relapse of apical prolapse after pectopexy reported by Noe after 21.8 months of follow‐up and none in the initial study by Banerjee . In the LLS technique group, objective cure rates at the 1‐year follow‐up were 91.6% for the anterior, 93.6% for the apical, and 85.3% for the posterior compartment …”

Section: Resultsmentioning

confidence: 64%

“…The concept of reconstructive repair includes both restoration of the descending compartment and preventive correction of unaffected compartments . In the studies analyzed in this review, surgery was often accompanied by concomitant procedures for other compartments and/or anti‐incontinence surgery, which lowered the risk of reoperation . These additional repairs contribute to the overall success of surgery and should be considered accordingly.…”

Section: Discussionmentioning

confidence: 99%

“…The area of fixation is 4 cm 2 , surrounded by external iliac vessels and obturator nerve. The part of the iliopectineal ligament at level S2 is an optimal anchor point for the physiological axis of the vagina . Typically, LASH precedes pectopexy.…”

Section: Introductionmentioning

confidence: 99%

“…The part of the iliopectineal ligament at level S2 is an optimal anchor point for the physiological axis of the vagina. 22 Typically, LASH precedes pectopexy. Research is ongoing with respect to a modified, uterus-preserving procedure, fixing the mesh to the anterior or posterior part of the uterus and pushing the mesh through the spaces created in the broad ligaments of the uterus.…”

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confidence: 99%

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Comparison of laparoscopic techniques for apical organ prolapse repair – a systematic review of the literature

Szymczak

Grzybowska

Wydra

2019

Neurourology and Urodynamics

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Aims Apical defect is a pelvic organ prolapse disorder, with 5%‐15% prevalence. The aim of the study was to investigate methods of laparoscopic repair of apical defect and compare them with other techniques (open, vaginal, and robotic). Methods A systematic search of the literature was conducted in MEDLINE/PubMed and ClinicalTrials.gov databases using the following key words: apical prolapse and treatment procedures. The search was limited by using the humans filters. Only articles published in English between 2010 and 2018 were considered. Two independent authors reviewed the publications for inclusion on the basis of the following criteria: (a) use of laparoscopic techniques, and (b) apical support loss as indication for surgery. Results A total of 1002 papers were initially identified; 24 studies fulfilled the inclusion criteria. Four main laparoscopic procedures were found. The reported anatomical success rate (POP‐Q < II stage) was 77%‐100%, with patient satisfaction for pectopexy, laparoscopic sacropexy (LS), lateral ligament suspension and laparoscopic uterosacral ligament suspension (LUSLS) of 96.4%‐97.6%, 71.0%‐100%, 66.7%‐87.8%, and 95%‐95.5%, respectively. Major complications included hemorrhage, bladder, ureter, and/or bowel injuries were rare. Prolapse recurrences after LUSLS and LS were reported in 13.2% and 10.4% of patients, respectively; with reoperation rate for LS 2.2%‐12.8%. Conclusions Most studies reported anatomical and subjective outcomes, with follow‐up ranging from 1 month to >7 years. Success rates for laparoscopic and abdominal corrections of apical defect were similar; laparoscopy was superior in terms of perioperative blood loss, length of hospital stay, and recovery.

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Section: Resultsmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of laparoscopic techniques for apical organ prolapse repair – a systematic review of the literature

Szymczak

Grzybowska

Wydra

2019

Neurourology and Urodynamics

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“…This study can be assigned to stage 1 of IDEAL-system. Another singlecenter randomized prospective clinical trial presented data on laparoscopic bilateral fixation of the vagina/cervix to the iliopectineal ligaments via a PVDF-mesh in 44 patients versus 41 standard laparoscopic sacropexies with PVDF-mesh [24]. The intermediateterm follow-up (21.8 months for pectopexy and 19.5 months for sacropexy) showed no mesh-related adverse events with high overall satisfaction (>95%).…”

Section: Discussionmentioning

confidence: 99%

Transvaginal PVDF-mesh for cystocele repair: A cohort study

Barski

Arndt

Gerullis

et al. 2017

International Journal of Surgery

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h i g h l i g h t sPVDF-mesh is feasible for transvaginal application for cystocele repair. 15% of patients presented any kind of complications and 8.8% needed a resurgery for SUI or POP during the follow-up. Improvement of quality of life was reported by 87.5% according the PGI-I. The preliminary results support the initiation of prospective trial and registry according to IDEAL. a r t i c l e i n f o Results: 34 women were eligible for a mean follow up of 19 months. The functional outcome improved significantly. One symptomatic vault prolapse (2.9%) and two reoperations for incontinence (5.9%) occurred. Two mesh exposures (5.9%) occurred and were treated conservatively. No other severe complications were registered. 87.5% of treated women felt very much better or much better and would undergo the surgery again. A cohort study including development steps in accordance with the IDEAL system is presented. Conclusions: For the first time we report on effectivity and safety of transvaginal application of PVDFmesh in real-life practice. A prospective long-term evaluation in a registry is justified.

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Efficacy of minimally invasive pectopexy with concomitant I‐stop‐mini sling for women with pelvic organ prolapse and overt stress urinary incontinence: A retrospective cohort study

Chao

Liu

Yang

et al. 2023

Intl J Gynecology & Obste

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Objective To compare the efficacy of minimally invasive pectopexy with I‐stop‐mini (MPI) and minimally invasive sacrocolpopexy with Obtryx (MSO). Methods Women with pelvic organ prolapse quantification (POP‐Q) stage III or more and overt stress urinary incontinence from May 2018 to May 2021 were included. Patients with meshes fixed on the cervix or vaginal vault and bilateral pectineal ligament with I‐stop‐mini were classified into the MPI group, while those fixed on the apex and sacral promontory with Obtryx were classified into the MSO group. The primary outcomes were 1‐year‐postoperative POP‐Q stage, patient‐reported urinary and prolapse outcomes (Urogenital Distress Inventory‐6, International Consultation on Incontinence Questionnaire‐Short Form, and Pelvic Organ Prolapse Distress Inventory‐6), 1‐h pad test, and sexual life quality (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire). Secondary outcomes included operative data and adverse events. Results The efficacy of MPI was similar to that of MSO according to the primary outcomes. MPI had shorter operative times (133.4 ± 30.6 min versus 199.3 ± 20.9 min, P = 0.001) and lower incidence rate of abdominal pain (0% vs 20%, P = 0.02) and groin pain (8% vs 40%, P = 0.01) than MSO. Conclusions MPI showed similar efficacy to MSO, but demonstrated shorter operative times and lower incidence rates of abdominal and groin pain.

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Laparoscopic Pectopexy: A Prospective, Randomized, Comparative Clinical Trial of Standard Laparoscopic Sacral Colpocervicopexy with the New Laparoscopic Pectopexy—Postoperative Results and Intermediate-Term Follow-Up in a Pilot Study

Abstract: Laparoscopic pectopexy is a novel method of vaginal prolapse therapy that offers clear practical advantages compared with laparoscopic sacropexy. Because laparoscopic pectopexy does not reduce the pelvic space, it results in a zero percentage of defecation disorders.

Cited by 86 publications

References 23 publications

Comparison of laparoscopic techniques for apical organ prolapse repair – a systematic review of the literature

Comparison of laparoscopic techniques for apical organ prolapse repair – a systematic review of the literature

Transvaginal PVDF-mesh for cystocele repair: A cohort study

Efficacy of minimally invasive pectopexy with concomitant I‐stop‐mini sling for women with pelvic organ prolapse and overt stress urinary incontinence: A retrospective cohort study

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