Initial Experience of Laparoscopic Pectopexy and Colporrhaphies in Finland

Abstract

Objective:

To evaluate initial outcomes of laparoscopic pectopexy combined with laparoscopic colporrhaphy for symptomatic pelvic organ prolapse during the surgeons’ learning curve.

Material and Methods:

The first 50 patients operated on between 8/2017 and 10/2020 for symptomatic vaginal vault or uterine prolapse POP-Q (Pelvic Organ Prolapse Quantification System) stage ≥ 2 were included. Data were collected retrospectively from medical records. The primary outcome measure was relief of prolapse symptoms; secondary outcome measures were anatomical results and perioperative complications at ∼4 months follow-up.

Results:

The relief of prolapse-related symptoms was achieved in the resolution of sensation of bulge in 74%, in voiding difficulty 89.7%, and in defecation difficulty 65.4%. De novo defecation symptoms developed in 4.2%. The mean operative time was 205 ± 50.3 minutes (111–400), and the mean EBL was 101 ± 74.7 mL (10–400). Simplified POP-Q classification measurements significantly improved postoperatively: Ba 3.84 ± 2.57 cm, C/D 8.86 ± 3.70 cm, Bp 2.42 ± 3.20 cm (p < .001). Complications included three urinary tract infections, one bladder injury, one symptomatic seroma, and one aspiration pneumonia. Anatomical recurrence rates were 4% at the apex, 31.3% after laparoscopic anterior colporrhaphy, 33.3% after laparoscopic posterior colporrhaphy, and 16.7% after combined posterior colporrhaphy techniques.

Conclusion:

Initial experience with laparoscopic pectopexy and colporrhaphy demonstrates favorable anatomical and symptomatic outcomes with low complication rates, even during the early phase of the learning curve. Concomitant repair of vaginal walls appears critical to optimal symptom relief. However, results are less favorable than in expert-level series, highlighting the need for further prospective evaluation.