A Novel Operative Procedure for Pelvic Organ Prolapse Utilizing a MRI-Visible Mesh Implant: Safety and Outcome of Modified Laparoscopic Bilateral Sacropexy

الملخص EN

Introduction.

Sacropexy is a generally applied treatment of prolapse, yet there are known possible complications of it.

An essential need exists for better alloplastic materials.

Methods.

Between April 2013 and June 2014, we performed a modified laparoscopic bilateral sacropexy (MLBS) in 10 patients using a MRI-visible PVDF mesh implant.

Selected patients had prolapse POP-Q stages II-III and concomitant OAB.

We studied surgery-related morbidity, anatomical and functional outcome, and mesh-visibility in MRI.

Mean follow-up was 7.4 months.

Results.

Concomitant colporrhaphy was conducted in 1/10 patients.

Anatomical success was defined as POP-Q stage 0-I.

Apical success rate was 100% and remained stable.

A recurrent cystocele was seen in 1/10 patients during follow-up without need for intervention.

Out of 6 (6/10) patients with preoperative SUI, 5/6 were healed and 1/6 persisted.

De-novo SUI was seen in 1/10 patients.

Complications requiring a relaparoscopy were seen in 2/10 patients.

8/10 patients with OAB were relieved postoperatively.

The first in-human magnetic resonance visualization of a prolapse mesh implant was performed and showed good quality of visualization.

Conclusion.

MLBS is a feasible and safe procedure with favorable anatomical and functional outcome and good concomitant healing rates of SUI and OAB.

Prospective data and larger samples are required.