Short-term safety and operative outcomes of sacrospinous ligament fixation using the Mendit device.

STUDY

OBJECTIVE

To evaluate short-term safety and operative outcomes of sacrospinous ligament fixation (SSLF) performed using a minimally invasive anchoring device (Mendit) for apical repair.

DESIGN

Retrospective single-arm cohort study.

SETTING

Tertiary care university-affiliated urogynecology centre.

PATIENTS: Women ≥21 years undergoing transvaginal SSLF with the Mendit anchoring system between January 2023 and June 2025 (n = 84).

INTERVENTIONS: Apical prolapse repair using anchoring device for SSLF performed via either conventional vaginal dissection or percutaneous incisionless technique, with or without concomitant procedures.

MEASUREMENTS AND MAIN

RESULTS

Mean age was 69.2 ± 11.1 years and mean BMI 26.7 ± 5.6 kg/m². Most patients had advanced prolapse (mean stage 3.6 ± 0.8). Bilateral fixation was performed in 67.9% of cases and concomitant procedures were common, including mid-urethral sling placement (40.9%). Mean operative time for the full procedure was 38.7 ± 14.9 minutes and estimated blood loss was 31.7 ± 42.2 mL. No intraoperative major organ injuries or transfusions occurred. Device malfunction occurred in <1% without clinical consequence. No serious postoperative complications (Clavien-Dindo >III) were observed. The most common adverse event was transient urinary retention (23.2%), resolving without intervention. Thirty-day reoperation occurred in 3.6% of patients. One urinary tract infection (1.2%) occurred. No early prolapse recurrences were identified. The percutaneous approach demonstrated shorter operative time and lower blood loss compared with conventional dissection.

CONCLUSION

Device-assisted sacrospinous ligament fixation demonstrates a favourable short-term safety profile with low complication and reoperation rates. The percutaneous technique may reduce operative time and tissue dissection while maintaining clinical safety. This approach represents a promising minimally invasive native-tissue alternative for apical prolapse repair.