Experience in treating apical pelvic organ prolapse in women using mesh implants

Abstract

Objective: to evaluate the results of surgical correction of pelvic organ prolapse using mesh implants.Materials and methods: experience in the treatment of pelvic organ prolapse using mesh implants on the basis of the Federal Siberian Scientific and Clinical Center of the Federal Medical and Biological Agency of Russia is presented. The features of the surgical technique for performing laparoscopic sacropexy and pectopexy, the advantages and disadvantages of both techniques, as well as the results obtained after surgery are considered.Results: during the period from 2016 to 2022, 567 surgical interventions using mesh implants were performed at the gynecology department. The effectiveness of POP correction using laparoscopic access reached 93.4% (p< 0.001). The recurrence rate of apical prolapse was 6.6% (p< 0.001). 20% of patients experienced constipation after sacropexy (p< 0.001), which was not observed after pectopexy. The prevalence of stress urinary incontinence de novo after laparoscopic sacropexy was 4.1%; this complication was not diagnosed after pectopexy. 37.4% of patients who underwent laparoscopic sacropexy reported dyspareunia, whereas 6.1% of women who underwent pectopexy had dyspareunia (p< 0.001). Also, in 0.64% of cases after urethropexy, a complication such as erosion of the vaginal wall was recorded (p< 0.001).Conclusions: laparoscopic sacropexy and pectopexy are effective methods of surgical correction of pelvic organ prolapse, and pectopexy has a number of advantages compared to sacropexy.

Keywords

• pelvic organ prolapse
• apical prolapse
• sacrocolpopexy
• pectopexy
• mesh implant