title: Laparoscopic pectopexy: a randomised comparative clinical trial of standard laparoscopic sacral colpo-cervicopexy to the new laparoscopic pectopexy. Short-term postoperative results.
abstract: OBJECTIVE
  Sacral colpopexy is a well established method of vaginal prolapse correction. Although it is capable of restoring the physiologic axis of the vagina, this method also bears some serious operative risks [1]. The aim of the study was to compare the laparoscopic sacral colpopexy with a laparoscopic bilateral fixation of the vagina/cervix to the iliopectineal ligaments via a PVDF-mesh (pectopexy).
  
  
  METHODS
  This part of a single-center randomized prospective clinical trial (Canadian Task Force Classification) compared the short-term operative outcome of laparoscopic sacropexy and pectopexy. We evaluated the operating time, blood loss, hospital stay duration, occurrence of major complications, episodes of constipation, urinary retention, de novo urinary incontinence, urinary tract infections, body mass index and postoperative Creactive protein values. The 1-year follow up examination will be carried out to evaluate the occurrence of relapse as well as late complications. Local symptoms and sexual activity will be evaluated using a German version of the ICIQ Vaginal Symptoms Questionnaire.
  
  
  RESULTS
  We carried out 43 pectopexies and 40 sacropexies in conjunction with other laparoscopic and/or vaginal procedures, as indicated. No major complications occurred in both groups during the hospital stay. There were no significant differences in the body mass index, average age, hospital stay duration and occurrence of constipation. The average operating time (43.1 vs. 52.1 min) and blood loss (4.6 vs. 15.3 ml) were significantly lower in the pectopexy group (p < 0.001).
  
  
  CONCLUSIONS
  Although laparoscopic pectopexy cannot yet be generally recommended as an alternative to sacropexy until the follow-up data is obtained, the new method can be considered in patients where the presacral preparation bears a higher risk of injury.
authors.affiliation: Hospital Dormagen, Teaching Hospital of the University of Cologne, Dr. Geldmacherstr. 20, 41539 Dormagen, Germany. karl-guenter.noe@kkh-ne.de
authors.forename: K G
authors.initials: KG
authors.lastname: Noé
authors.forename: C
authors.initials: C
authors.lastname: Spüntrup
authors.forename: M
authors.initials: M
authors.lastname: Anapolski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002584:Cervix Uteri / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012445:Sacrococcygeal Region; D013526:Surgical Mesh; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery*