Work

Unilateral pectineal suspension with mesh as a rescue procedure when sacrocolpopexy is not feasible: a case series

Year: 2025

Type: article

Abstract: Laparoscopic sacrocolpopexy (SCP) is the gold standard for apical prolapse, but presacral dissection may be unsafe or infeasible due to anatomical or surgical barriers. In such cases, alternative fixation methods are needed. We report three elderly women with advanced apical prolapse in whom robotic SCP was converted intraoperatively: one due to redundant sigmoid and bulky presacral vessels, one due to a fibrotic promontory with adherent vessels from prior spinal surgery, and one due to bowel redundancy and adhesions. All underwent unilateral pectineal suspension (UPS) with a lightweight mesh anchored to the right iliopectineal ligament when promontofixation was not feasible. UPS provided stable apical support and functional improvement in all cases. At follow-up, one showed mild asymptomatic mid-compartment descent, one had improved bladder emptying with persistent OAB, and one had excellent correction with mild residual stress incontinence. UPS with mesh is a safe, effective intraoperative alternative when SCP is not feasible.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf1094

Authors: Leandro Nobrega, Jerome Mathis, Dimitrios Bolovis, Cosima Brucker, Caroline Eggemann

Institutions: Spitalzentrum Centre hospitalier Biel- Bienne, Paracelsus Medical University, Paracelsus Medizinische Privatuniversität

Language: English

Topic: Pelvic floor disorders treatments

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000