Abdominal Mesh Colpopexy Without Promontory Fixation: 10-Year Follow-up Results of the Peritoneocolpopexy Technique

OBJECTIVE To restore apical vaginal prolapse support when the access to the promontory is challenging, a modified method of colpopexy may be needed. We present our 10-year results on the peritoneocolpopexy (PCP) technique without promontory fixation relying on unidirectional barbed delayed absorbable sutures (V-Loc). METHODS Fourteen women who underwent PCP for vaginal vault prolapse between 2011 and 2014 participated in an IRB-approved prospective study (11 noninfected; 3 with infected mesh needing lapse quantifications (POP-Q), complications, reoperations, and secondary prolapses were collected. Paired statistical analyses compared various timepoints and mixed model analysis assessed questionnaire and POP-Q trends over time. RESULTS Median follow-up was 9.7 years (interquartile range (IQR): 6.0-0.7) to last POP-Q and 10.4 years (IQR: 9.6-11.5) to last contact. No patients were lost to follow-up. Mean baseline C point for all patients was - 4.3 and - 2.9; 1-year C point was - 9.1 and - 9.2 and - 8.6 and - 8.5, respectively at last visit. POP-Q findings improved between pre-PCP and 1-year post surgery and did not significantly change until the last visit. Trends in UDI-6, IIQ-7, QoL, and POP-Q findings showed no significant change in any category per year (95% confidence interval (CI), P = .2-.9). Secondary anterior compartment prolapse was noted in 3 patients with 1 requiring a repair. CONCLUSION PCP provides durable vaginal apical support when access to the promontory is compromised. PCP can also be used to prevent secondary prolapse after an infected mesh removal. UROLOGY 193: 73-76, 2024. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.