Laparoscopic Fixation of the Anterior Perineal Suspension Axis to the Bilateral Pectineal Ligaments for Recurrent Pelvic Organ Prolapse

Background & Objective: Pelvic Organ Prolapse (POP) is a common condition among women, particularly those who are postmenopausal or have a history of multiple childbirths, significantly impairing their quality of life. Despite the availability of various surgical approaches-such as hysterectomy or sacrocolpopexy-recurrence remains a persistent challenge. This study presents the surgical technique and evaluates the therapeutic outcomes of Laparoscopic Fixation of the Anterior Perineal Suspension Axis to the Bilateral Pectineal Ligaments (LAPSPL) in the treatment of Recurrent Pelvic Organ Prolapse (RPOP) at Hanoi Medical University Hospital. Materials & Methods: A retrospective descriptive study was conducted on ۲۷ patients diagnosed with RPOP who underwent LAPSPL between June ۲۰۲۱ and December ۲۰۲۴. Results: The study included ۲۷ women with RPOP, with a mean age of ۶۶.۰ years and a mean BMI of ۲۱.۸ kg/m². The mean operative time was ۹۰.۷ minutes, and the mean length of hospital stay was ۲.۱ days. After a mean follow-up period of ۲۴.۴ months, POP severity improved from ۳.۷۴±۰.۴۵ to ۰.۳۷±۰.۶۳ (P<۰.۰۰۰۱), and cystocele grade decreased from ۲.۱۴±۰.۳۸ to ۰.۳۱±۰.۴۸ (P<۰.۰۰۰۱), based on the Baden-Walker classification. Postoperative quality of life improved significantly, with PFDI-۲۰ scores decreasing from ۱۰۵.۲ to ۱۵.۲ and PFIQ-۷ scores from ۹۱.۳ to ۱۳.۴ at six months. No complications or recurrences were reported. Conclusion: LAPSPL is a safe and minimally invasive surgical option for RPOP, offering effective anatomical correction, improved quality of life, and low complication and recurrence rates.

Keywords:

Pelvic organ prolapse , Recurrence , pubocervical fascia , laparoscopy , pectineal ligament , anterior perineal suspension axis