Safety and efficacy outcomes of a novel hysterosacropexy: A fertility sparing, uterine preserving pelvic organ prolapse surgery

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Benha University, Benha, Egypt,

2 Department of Obstetrics and Gynecology, Faculty of Medicine, Benha University, Egypt

Abstract

Objective: To access the safety and efficacy outcomes of a new abdominal Hysterosacopexy with CESA (Cervico-sacropexy) DynaMesh kit in treating advanced uterovaginal prolapse in young women aiming in uterine preservation pelvic organ prolapse (POP) surgery.
Patients and Methods: Prospective nonrandomized controlled clinical trial enrolled consecutive women attending the gynecology and obstetrics Department, Benha University Hospital for treatment of POP of stage II or greater on POP quantification (POPQ) system on the apical domain. Participants underwent abdominal hysterosacropexy utilizing CESA mesh kit of DynaMesh. POPQ staging, women symptoms, and quality of life were evaluated before and after surgery, as well as surgery-related morbidity.
Results: The current study enrolled 20 women, all women were followed up for a period of 18 months postoperatively. Significant post-surgical anatomical success was recorded across both POPQ anterior (point Aa, Ba) (P ≤ 0.0001, P ≤ 0.0001), apical (point c, d) (P ≤ 0.0001, P≤ 0.0001) and Posterior (point Ap, Bp) (P ≤ 0.0001, P≤ 0.0001) domains. Significant post-surgical functional improvements were recorded across prolapse symptoms, (bulge symptoms, overactive bladder, stress urinary incontinence, bowel dysfunction, sexual dysfunction) (P ≤ 0.0001, P = 0.0064, P = 0.03, P = 0.008, P ≤ 0.0001) respectively. ICIQ-VS (VS – SS – QOL) score (P≤ 0.0001, P ≤ 0.0001, P ≤ 0.0001). ICIQ – UI – SF score (P ≤ 0.0001). No major complications occurred. No mesh erosions were reported.
Conclusion: Abdominal hysterosacropexy with CESA DynaMesh kit seems to be a safe and effective option for women with advanced uterovaginal prolapse aiming for uterine preserving POP surgery.

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