Long-term results of apical prolapse correction by unilateral pectineal suspension: a clinical trial

Introduction. Unilateral pectineal suspension (UPS) is a novel method for mesh-free apical prolapse correction. Short-term follow-up results 6 months after isolated UPS have been very encouraging, resulting in excellent apex stability and high patient satisfaction in a cohort of 47 patients with mostly advanced prolapse.

Aim. To evaluate the apex stability and the frequency of residual defects requiring secondary surgery 24 months after isolated UPS.

Materials and methods. In order to assess the long-term outcome after isolated UPS, all 47 patients from the original patient cohort treated with isolated UPS were invited for a scheduled follow-up examination after a minimum follow-up period of two years to determine whether the result of the primary surgery remained stable. We analyzed the outcome with regard to apex stability, residual defects, and procedure-related morbidity.

Results. UPS as a stand-alone procedure showed high stability at the apex. Throughout the two-year follow-up period, only 2 (4.3 %) patients required secondary surgery for apical recurrence. Increasing age correlated significantly with apical recurrence. Six (13.0 %) patients became symptomatic in the anterior and/or the posterior compartment while the apex remained stable. With increasing age, the probability of secondary surgery also appeared to rise, however, this was not statistically significant. There was no method-related morbidity.

Conclusion. Two-year follow-up after isolated UPS shows stable results at the apex. A combined approach may be valuable to reduce the potential necessity of secondary surgery in the anterior/posterior compartment.

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