AIMS: To present our experience and early outcomes utilizing a new technique for mesh anchorage during open sacrocolpopexy, termed peritoneocolpopexy (PCP).
METHODS: Prospective patient study from an IRB approved sacrocolpopexy database that underwent a mesh PCP was analyzed. Data included complications, validated questionnaires, POP-Q examination and associated outcomes.
SURGICAL TECHNIQUE: Following placement of a Marlex® mesh anteriorly and posteriorly to the vaginal apex, the tail of the mesh is positioned in a peritoneal groove extending towards the promontory. The mesh is secured to surrounding tissues (peritoneum and fat underneath) with 2 running 2-0 V-Loc™ 180 (unidirectional barbed delayed absorbable) sutures placed on either side of the mesh tail well below the promontory.
RESULTS: Fourteen patients were identified from our prospective database. Mean age and follow-up were 60.5 years (28-82) and 19.6 months (7-38.3) respectively. Mean preoperative C-point was was - 2.7 (2 to -10) compared to -9.5 (-8 to -12) postoperatively (p < 0.003). No prolapse recurrence was noted. Mean operative time, blood loss and postoperative hospital stay were 238 minutes (160-300), 129 ml (20-900) and 3 days (1-6) respectively. Functional outcome improvement was statistically significant for total UDI-6; 6 to 3 (p = 0.04), QoL: 4.1 to 2.1 (p < 0.27) and IIQ-7: 6 to 2 (p = 0.3), respectively.
CONCLUSION: PCP performed reliably to correct symptomatic POP with satisfactory anatomic outcomes for apical support. Longer term follow-up is required to fully assess durability of repair.
Written by:
Lee D, Zimmern PE. Are you the author?
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
Reference: J Urol. 2015 Jan 23. pii: S0022-5347(15)00175-5.
doi: 10.1016/j.juro.2015.01.085
PubMed Abstract
PMID: 25623750