Retrospective analysis of apical prolapse correction by unilateral pectineal suspension: perioperative and short-term results

Abstract

Introduction and hypothesis We have previously published the novel method of unilateral pectineal suspension (UPS) for apical prolapse correction. UPS provides mesh-free midline uterus suspension using a single non-absorbable suture to attach the anterior cervix to the lateral part of the iliopectineal ligament. The purpose of this retrospective cohort study was to analyze the short-term efficacy, perioperative complication rate, and overall patient acceptance of the new UPS surgical concept. Methods Forty-seven patients with POP-Q stage 2–4 who underwent robotic UPS between January 1, 2020 and December 31, 2021 were included in the study. Patient data were taken retrospectively from the patient files. Treatment success was the primary endpoint, measured both objectively using a defined composite endpoint and subjectively according to patients’ acceptance 3–6 months after surgery during a follow-up examination. Secondary outcome measures included complications and conversions, and effect of additional procedures on operative time. Results Treatment success as measured by the defined composite endpoint was 93.6% for the entire cohort. No complications or conversions occurred. Mean operation time for isolated UPS was 46.5 min (n = 33 patients). UPS can be easily combined with additional surgical procedures for repair of remaining pelvic floor defects, incontinence surgery or other indications. Additional procedures performed had a significant influence on operation time (p < 0.0005, n = 14). Conclusions UPS shows highly favorable results when looking at an unselected cohort of patients in need of primary POP surgery with respect to established quality parameters of POP repair.

Apical prolapse correction by unilateral pectineal suspension

“…Recently, the method of unilateral pectineal suspension (UPS) was established for uterus-preserving mesh-free apical POP correction [ 4 ]. A retrospective analysis of 47 patients revealed excellent short-term results with a subjective and objective treatment success of 93.6% as defined by a standardized composite endpoint [ 5 ].…”

Assessment of pelvic organ prolapse with the Pelvic Inclination Correction System: defining the normal range and threshold to pathology

“…Despite the existing limitations with regard to symptom correlation with clinical and MRI findings in pelvic organ prolapse, dynamic MRI of the pelvis is not only useful in the work-up of patients with pelvic floor disorders but could play an important role as part of a composite endpoint metric in patients treated for symptomatic pelvic organ prolapse in the future [ 29 ]. Composite endpoints often combine subjective and objective metrics to get a better picture of outcome, since single endpoints such as patient-reported symptoms can be subjective and variable.…”

Total Pelvic Floor Lifting: A New Approach for the Anatomic Repair of Pelvic Floor Hypermobility and Vaginal Laxity in Parous Women

“…No unexpected complications were observed. 11 Furthermore, in the case series of over 400 procedures performed, we have until now no cases with bowel disorders, ureter or bladder complications or de novo incontinence, nor the need for re-operation (unpublished data). The straightforward concept performance (avoiding dissection of critical structures) allows for an accurate evaluation of the postoperative symptoms of the patient.…”