Laparoscopic Pectopexy: A Novel Technique to Manage Pelvic Organ Prolapse; An Original Study in Asian Women in Rural Area.

Abstract

Background: Pelvic organ prolapse is a common gynecological disorder seen in Asian women, more in rural area. It is seen in both old age and young women. Presenting complaints includes something coming out of vagina, chronic pelvic pain, urinary and bowel symptoms. Sacrohysteropexy is the gold standard procedure for its management. Recently, laparoscopic pectopexy is described as a new alternative procedure, which is equally effective and associated with far lesser complications. Thus, this study is conducted to see the outcomes of laparoscopic pectopexy.

Method: This retrospective observational study is conducted in the department of obstetrics and gynecology, over the period of three years. Thirty-five patients, operated by laparoscopic pectopexy, were included in study. Twenty-five cases were young patient with prolapse, while 10 patients were of vault prolapse. Inclusion criteria were POP-Q stage ≥ II. All cases were done by same surgical team. Data were analyzed in terms of demographic profile. Video recording of surgery were checked to calculate operating time and estimated blood loss. All intraoperative and postoperative complications were recorded. Follow-up was done at 1 month and 6 months.

Results: Out of 35 cases, 10 were vault prolapse and 25 cases were uterine prolapse. No major intraoperative complications like visceral injury and major hemorrhage were found. Average operating time was 96 min. Average estimated blood loss was 50-100 ml. All patients were followed up at 1 month, 3 months and 6 months postoperatively. All patients were highly satisfied with surgery. None of the patients had de novo apical prolapse/recurrence of symptoms.

Conclusion: Laparoscopic pectopexy is a novel promising technique to manage prolapse with minimal intraoperative and postoperative complications. It is a safe and feasible alternative to sacropexy. So, it should be considered as a first-line surgery for management of apical prolapse.