A Novel Approach for Apical Prolapse Surgery: Meshless Pectopexy (Salman’s Modification)

Erdem B., Salman S., Usta Z. K., Bacak H. B., Özkan M. D., Çeken A. T., ...Daha Fazla

International Urogynecology Journal, cilt.36, sa.8, ss.1701-1705, 2025 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 36 Sayı: 8
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s00192-025-06107-z
  • Dergi Adı: International Urogynecology Journal
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.1701-1705
  • Anahtar Kelimeler: Apical prolapse, Meshless, Minimally invasive, Pectopexy, Pelvic organ prolapse
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Introduction and Hypothesis: This video demonstrates the laparoscopic meshless pectopexy with uterine preservation (Salman's modification). Methods: This study in a single group semi-experimental design was carried out in a secondary center. From May 2022 to April 2024, a total of 40 consecutive symptomatic women with stage 3–4 apical prolapse requesting uterine protection were included in the study. Without using mesh, patients received a laparoscopic pectopexy using monofilament non-absorbable sutures and preserving the uterus. Pelvic organ prolapses quantitative stage 2 or higher, especially in the central compartment (C ≥—1), and anatomical recurrences of genital prolapse were recorded. Results: In the 1st postoperative year, patients showed a significant improvement in the Pelvic Organ Prolapse Quantification central compartment (C score: mean difference −8.21 ± 3.03, 99% confidence interval −9.20 to −7.21) and in all other landmarks (p < 0.001). Apical prolapse recurrence occurred in 7.9% of cases and stage 3Bp prolapse developed in one patient during the follow-up period. Sexual function and urinary symptom scores (PISQ-12) were significantly improved after surgery. Conclusions: Laparoscopic meshless pectopexy represents an effective and feasible option for the surgical treatment of uterovaginal prolapse, preserving the uterus and preventing postoperative complications associated with mesh use.