Abdominal mesh sacrocolpopexy without promontory fixation: initial results of the peritoneocolpopexy technique.

PURPOSE: We present our experience and early outcomes using a new technique for mesh anchorage during open sacrocolpopexy called peritoneocolpopexy.

MATERIALS AND

METHODS

A prospective review of patients from an institutional review board approved sacrocolpopexy database who underwent mesh peritoneocolpopexy was performed. Data included complications, validated questionnaires, pelvic organ prolapse quantification examination and associated outcomes. After placement of a Marlex® mesh anteriorly and posteriorly to the vaginal apex, the tail of the mesh is positioned in a peritoneal groove extending toward the promontory. The mesh is secured to surrounding tissues (peritoneum and fat underneath) with 2 running 2-zero 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 followup were 60.5 years (range 28 to 82) and 19.6 months (range 7 to 38.3), respectively. Mean preoperative C-point was -2.7 (range 2 to -10) compared to -9.5 (range -8 to -12) postoperatively (p <0.003). No prolapse recurrence was noted. Mean operative time, blood loss and postoperative hospital stay were 238 minutes (range 160 to 300), 129 ml (range 20 to 900) and 3 days (range 1 to 6), respectively. Functional outcome improvement was statistically significant for total UDI-6-6 to 3 (p = 0.04), quality of life-4.1 to 2.1 (p <0.27) and IIQ-7-6 to 2 (p = 0.3), respectively.

CONCLUSIONS

Peritoneocolpopexy performed reliably to correct symptomatic pelvic organ prolapse with satisfactory anatomical outcomes for apical support. Longer term followup is required to fully assess durability of repair.