gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Abdominal Pectopexy versus Abdominal Sacral Hysteropexy as conservative surgeries for genital prolapse: A Randomized Control Trial


Author(s): Ghaleb M, Abd El-Hameed M, Abdel Kader A, Mokhtar M* and Mamdouh A

Background: Pectopexy is a new technique for apical repair in which lateral parts of the iliopectineal ligament are used for cuff or cervix suspension. This new method is considered a simple, safe procedure, especially in patients whose surgical exploration is difficult. Abdominal sacral hysteropexy remains a viable alternative for women undergoing pelvic reconstructive surgery who wish to retain their uteri, providing comparable rates of overall improvement and symptom change.

Aim of the work: The aim of the study is to compare between abdominal pectopexy and abdominal sacral hysteropexy in terms of operative time.

Methods: This prospective randomized control study was performed on total 80 patients who were diagnosed with pelvic organ prolapse in Ain Shams University hospital from May 2019 to May 2021 with women of any parity included in the study with stage 2 to 4 uterine prolapse, BMI from ≤ 35 kg\m2 and age group from 20 to 40 years. Women with previous correction of apical prolapse and co-existing uterine pathology e.g. uterine fibroid were excluded from the study.The women involved in the study were divided into two groups: Group A: 40 women who underwent abdominal pectopexy and Group B: 40 women who underwent abdominal sacral hysteropexy.

Results: Operation duration was significantly shorter among Pectopexy group than among Hysteropexy group. Intraoperative blood loss was significantly lower among Pectopexy group than among Hysteropexy group. No significant difference between the studied groups regarding preoperative and postoperative hemoglobin. Postoperative hemoglobin drop was significantly lower among Pectopexy group than among Hysteropexy group. Postoperative pain at hour 24 was significantly lower among pectopexy group. Postoperative constipation was significantly recorded only in hysteropexy group. Postoperative blood transfusion was not recorded in both groups. Postoperative hospital stay was non-significantly shorter among Pectopexy group than among Hysteropexy group. Relapse was non-significantly more frequent in pextopexy group, while Stress urinary incontinence was non-significantly less frequent in pextopexy group. Sexual dysfunction was not recorded in the study groups.

Conclusion: As evident from the current study, Pectopexy is a safe, effective and feasible alternative approach in management of pelvic organ prolapse with significantly shorter operation time. Moreover, it is associated with minimal intraoperative and postoperative complications, so should be preferred over sacrohysteropexy in management of pelvic organ prolapse.