A.S. SHCHUKINA, I.D. KLYUSHNIKOV, A.A. POPOV, A.A. FEDOROV

Moscow Regional Scientific-research Institute of Obstetrics and Gynecology named after Acad. V.I. Krasnopolsky, Moscow

Contact details:

Shchukina A.S. — post-graduate student

Address: 22a Pokrovka St., Moscow, Russian Federation, tel.: +7-916-745-34-70, e-mail: shchukina007@mail.ru

 The increasing life expectancy in the modern world necessitates research aimed at improving the outcomes of surgical treatment for pelvic organ prolapse (POP) while minimizing recurrence rates.

The purpose — to compare the efficacy of various surgical approaches for apical POP repair using monofilament polypropylene mesh prostheses.

Material and methods. The single-center non-randomized retrospective-prospective study included 189 women with POP-Q stage II–IV. Patients were divided into group I (n = 94), who underwent vaginal anterior bilateral sacrospinous fixation with the Dallop NM’ mesh, and group II (n = 95), who underwent laparoscopic sacrocolpopexy with the Esfil Light mesh.

Results. The study revealed that the vaginal approach was associated with greater blood loss (62.2 ± 20.1 vs. 26.1 ± 11.9 mL; p < 0.001) and more pronounced pain, while laparoscopy required longer operative time (118.6 ± 12.7 vs. 64.0 ± 14.6 min; p < 0.001). Group I had higher rates of vaginal erosion (8.4 vs. 0%; p < 0.004), chronic pelvic pain (24.2 vs. 7.4%; p < 0.001), and de novo stress urinary incontinence (26.3 vs. 13.8%; p < 0.03). Both methods showed low POP recurrence rates, but group II had more frequent cystocele (p < 0.03). Both techniques demonstrated high efficacy but differed in complication profiles, necessitating an individualized surgical approach.

Conclusion. Sacrocolpopexy provides stable results and is preferable for complex and recurrent cases. Bilateral sacrospinous fixation is less invasive and suitable for patients with a high risk of abdominal operations, but carries a higher risk of de novo stress incontinence. The choice of method should take into account patient-specific factors and surgeon expertise.

Key words: pelvic organ prolapse, sacrospinous fixation, sacrocolpopexy, mesh prosthesis.

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