Laparoscopic Retrovesical Colpopectinopexy-A New Approach in Prolapse Surgery: Preliminary Results

Objective: Female pelvic organ prolapse (POP) is one of the main reasons for quality-of-life impairment in women. Urinary incontinence and sexual disorders are among the most frequent complaints. Several kinds of procedures in different surgical approaches exist but none has been accepted as a "gold standard." The goal of this research was to assess a new technique, laparoscopic retrovesical colpopectinopexy (LRC) for POP. Materials and Methods: LRC was assessed for safety and long-term outcomes ina retrospective review of medical records and telephone call interviews of 22 consecutive patients who underwent LRC for POP from December 2011 through September 2015. LRC with use of polypropylen meshes was performed in all cases, using three trocars. All procedures were performed in one clinic by 1 surgeon. Age, comorbidities, operation times, blood losses, recovery of bowel functions, length of postoperative hospital stays, wound infections, and intra- and postoperative complications were recorded. All women were followed-up with telephone call questionnaires at 3 months and at 1 year. All women were asked to come in for observation at 1 year. Results: The mean operative time was 72 minutes (range: 44-121 minutes). There were no conversions for open surgery nor any intraoperative or postoperative complications. First bowel movements were observed on the first postoperative day (POD) in all women. All women were discharged from the hospital on POD 4. The questions asked during the follow-ups were: (1) "Do you have any complaints that could be related to the operation?" (2) "Did your problems recur?" (3) "Are you satisfied with the procedure overall?" All of the women's answers were negative for questions 1 and 2 and positive for question 3. At 1 year, 16 women were seen and were assessed with the Pelvic Organ Prolapse Quantification System. Persistence of POP was not observed. One patient with stage 3 POP was downgraded to stage 1. Conclusions: LRC is a safe and effective method for all types of cystocele repairs. It produces no intra- or postoperative complications. The operative time is short, and the procedure is easy to learn.