Evaluation of the mid-term surgical outcomes of vNOTES sacrocolpopexy and vNOTES high uterosacral ligament suspension in pelvic organ prolapse


Birol Ilter P., Keles E., Kirlangic M. M., YILDIZ G., TEKİN A. B., Budak D., ...Daha Fazla

Minimally Invasive Therapy and Allied Technologies, cilt.34, sa.4, ss.310-317, 2025 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 34 Sayı: 4
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1080/13645706.2025.2500095
  • Dergi Adı: Minimally Invasive Therapy and Allied Technologies
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.310-317
  • Anahtar Kelimeler: Gynecological surgeries, natural orifice transluminal endoscopic surgery, uterosacral ligament suspension, pelvic organ prolapse
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Background: This multicenter retrospective study aimed to assess the surgical outcomes of vNOTES-HUSLS and sacrocolpopexy after vNOTES hysterectomy for apical pelvic organ prolapse (POP). Methods: A total of 101 patients were included. Pre and postoperative modified POP-Q scores, postoperative Visual Analog Scale (VAS) scores and complications were among the information gathered. POP-Q-C score of less than −1 cm was considered an apical recurrence. ‘Overall success’ was defined as the absence of each of the following factors: ≥ Stage 2 POP (in any compartment), retreatment for prolapse. Results: vNOTES-HUSLS (n = 78) achieved an overall success rate of 92.2%, accompanied by a low intraoperative complication rate of 2.6% (n = 2) at the 23-month median follow-up. vNOTES-sacrocolpopexy (n = 23) achieved an anatomical success rate of 78.3% and exhibited a low intraoperative complication rate of 4.3% (n = 1) at the 21-month median follow-up. The apical prolapse recurrence rate was 2.6% and 8.7% in the HUSLS and sacrocolpopexy groups, respectively (p = 0.185). Total duration of surgery and VAS scores were significantly lower in the vNOTES-HUSLS group than in the vNOTES-sacrocolpopexy group. Conclusions: In POP surgery, HUSLS and sacrocolpopexy may be performed using the vNOTES technique depending on the patient’s preference for natural tissue repair or mesh use.