E-Posters-Positive Effects of Vaginal Bilateral Hysteropexy with a Mesh Tape on Prolapse Symptoms and Patients Satisfaction in Women with Severe Pelvic Organ Prolapse

Positive Effects of Vaginal Bilateral Hysteropexy with a Mesh Tape on Prolapse Symptoms and Patients Satisfaction in Women with Severe Pelvic Organ Prolapse - Gert Naumann, PhD, MD

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This prospective observation study examined the effects of vaginal bilateral hysteropexy with Splentis® on symptoms and quality of life in women with severe pelvic organ prolapse (POP). The study included 182 patients with apical prolapse, aged between 37 and 93 years. The surgical procedure, which involved uterus-sparing vaginal bilateral sacrospinous hysteropexy with anterior fascial plication, was successfully performed in all cases with no intraoperative complications.<br /><br />The mean operation time was 23 minutes, and the mean postoperative pain rating on a visual analog scale was 0.6. The average hospital stay was 3.4 days, and all patients were discharged with residual urine less than 100 ml. After 4-12 months, 3 cases of granulation polyps related to suturing material were observed, but there were no cases of dyspareunia. All patients showed improvement in POP symptoms, with a POP-Q score of ≤1.<br /><br />There were minimal side effects or complications observed, with one patient experiencing pelvic pain and one patient developing hydroureteronephrosis due to kinking of the ureter during the surgery. Four patients developed stress urinary incontinence and were treated separately with a suburethral sling. The majority of patients (97%) reported being satisfied or very satisfied with the results of the intervention.<br /><br />Based on these results, the study suggests that uterus-sparing vaginal bilateral sacrospinous hysteropexy with Splentis® can significantly improve symptoms and patient satisfaction in women with severe POP, without severe side effects or complications. The short operation time of under 25 minutes is particularly beneficial for older patients. The study also highlights the importance of permanent fixation of the vaginal apex or uterus, suggesting that large alloplastic meshes may not be necessary in many cases.<br /><br />The ongoing observation includes a follow-up examination of almost 50% of the patients. Data was collected preoperatively, postoperatively, and at 3-12 months follow-up, including pain and satisfaction ratings, as well as validated pelvic floor questionnaires. Statistical analysis was conducted using descriptive evaluation methods.<br /><br />The Splentis® apical suspension system used in the study offers a minimal invasive anchoring system for suspending the vaginal vault or cervix back to its natural position using a small mesh string attached to the sacrospinous ligament.

Keywords

vaginal bilateral hysteropexy

Splentis®

pelvic organ prolapse

POP

complications

operation time

patient satisfaction

follow-up examination

pelvic floor questionnaires

minimal invasive anchoring system