The following is a summary of “Abdominal Mesh Colpopexy Without Promontory Fixation: 10-Year Follow-up Results of the Peritoneocolpopexy Technique,” published in the September 2024 issue of Urology by Papp et al.

When addressing apical vaginal prolapse in cases where access to the sacral promontory is difficult, alternative techniques may be necessary to achieve effective support. This study presents a 10-year analysis of the peritoneocolpopexy (PCP) technique, which omits promontory fixation and utilizes unidirectional barbed delayed absorbable sutures (V-Loc). About 14 women who underwent PCP between 2011 and 2014 for vaginal vault prolapse were included in this IRB-approved prospective study. Eleven women had noninfected prolapse, while three required mesh excision due to infection. Long-term follow-up data, including validated questionnaires such as the Urinary Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and Quality of Life (QoL) assessments, were collected alongside pelvic organ prolapse quantifications (POP-Q), complications, reoperations, and occurrences of secondary prolapse. 

Statistical analyses compared outcomes at various time points, and mixed model analysis evaluated trends over the study period. The median follow-up duration was 9.7 years for POP-Q assessments and 10.4 years for last patient contact, with no patients lost to follow-up. At baseline, the mean C point for all patients was −4.3 and −2.9, improving to −9.1 at 1-year follow-up and remaining stable at −8.6 to −8.5 at the final visit. POP-Q scores demonstrated significant improvement between the preoperative and 1-year postoperative periods, with no notable changes observed throughout the follow-up period. Trends in UDI-6, IIQ-7, QoL, and POP-Q remained consistent over time, with no statistically significant variation per year (95% CI, P = .2-.9). Secondary prolapse in the anterior compartment was observed in three patients, with one requiring surgical repair. 

Overall, the PCP technique proved effective in providing long-term vaginal apical support, particularly in cases where access to the promontory was challenging. Additionally, PCP demonstrated utility in preventing secondary prolapse following the removal of infected mesh, supporting its durability and potential as a reliable alternative for apical support in complex cases.

Source: sciencedirect.com/science/article/abs/pii/S0090429524007659