Laparoscopic Pectopexy for Recurrent Pelvic Organ Prolapse after Laparoscopic Sacrocolpopexy

Laparoscopic sacrocolpopexy (LSC) provides excellent long-term anatomic and functional results [ 1 Grinstein E Abdelkhalek Y Veit-Rubin N Gluck O Deval B. Long term outcomes of laparoscopic sacro/colpo-hysteropexy with and without rectopexy for the treatment of prolapse. Int Urogynecol J. 2022; 33: 343-350 Crossref PubMed Scopus (3) Google Scholar ], with a 3.7% cumulative prolapse recurrence after LSC over 10 years’ follow-up [ 2 Kotani Y Murakamsi K Kai S Yahata T Kanto A Matsumura N. Comparison of surgical results and postoperative recurrence rates by laparoscopic sacrocolpopexy with other surgical procedures for managing pelvic organ prolapse. Gynecol Minim Invasive Ther. 2021; 10: 221-225 Crossref PubMed Scopus (1) Google Scholar ]. Surgery for recurrent pelvic organ prolapse (POP) after LSC is debated. A reoperation, when the sacral promontory has been dissected anteriorly, can be associated with bowel, ureteral, and vascular injuries due to distorted anatomy [ 3 Rusavy Z Abdelkhalek Y Najib B Deval B. Laparoscopic synthetic mesh explantation after sacrohysteropexy. Int Urogynecol J. 2022; 33: 2049-2051 Crossref PubMed Scopus (1) Google Scholar ]. A new procedure was described in 2007 to treat female POP: laparoscopic pectopexy (LP) [ 4 Banerjee C Noé KG. Laparoscopic pectopexy: a new technique of prolapse surgery for obese patients. Arch Gynecol Obstet. 2011; 284: 631-635 Crossref PubMed Scopus (45) Google Scholar ]. This consists of a bilateral vaginal cuff suspension on the pectineal ligaments using synthetic mesh. Placement of the tape does not interfere with organs, vessels, or nerves, and it does not disturb the rectum or the hypogastric plexus [ 5 Noé GK Schiermeier S Papathemelis T et al. Prospective international multicenter pelvic floor study: short-term follow-up and clinical findings for combined pectopexy and native tissue repair. J Clin Med. 2021; 10: 217 Crossref Scopus (3) Google Scholar ].