Positive effects of vaginal bilateral hysteropexy with Splentis-tape on prolapse symptoms and quality of life in women with severe pelvic organ prolapse

Purpose:

To evaluate the improvement of symptoms and quality of life after uterus-sparing vaginal bilateral hysteropexy with Splentis-tape in women with severe pelvic organ prolapse.

Patients and methods:

Between May 2017 and May 2018 96 patients with uterus prolapse POP-Q > II, aged 41 – 87, were enrolled in this prospective study. All participants responded pelvic floor questionnaires and urogynecological examination preoperatively, 6 and 12 months postoperatively.

Results:

Uterus-sparing vaginal bilateral sacrospinous hysteropexy with anterior fascial plication was successfully performed in all cases. Mean operation time was 28 min (13 – 63). No intraoperative complications like bladder lesion, infection, bleeding > 200 ml, eg occurred. Initial mean postoperative pain VAS 0 – 10 was 0.8. Hospital time was 3.4 days, demission at home in all cases with residual urine less 100 ml. After 6 – 12 months there were no erosion or dyspareunia. All patients showed POP-Q ≤ I. 2 patients had pelvic pain VAS 4, 1 patient had hydronephrosis due to kinking ureter through colporrhaphia anterior with insertion of DJ stent. 4 patient developed demasked stress urinary incontinence and were treated with suburethral sling separately.

Conclusion:

According to our results, 6 – 12 months after uterus-sparing vaginal bilateral sacrospinous hysteropexy with Splentis-tape patients have significant improvement of prolapse symptoms and general quality of life without severe side effects or complications. Older patients profit from short OR-time. Permanent fixation of vaginal apex/uterus should be focussed, it seems no need for large alloplastic meshes in this situation.