First experience with infracoccygeal sacropexy according to Petros in vaginal prolapse and urinary urge incontinence

Objective: The infracoccygeal sacropexy (ICS) according to Petros is a surgical procedure with a tension free tape for repair of vaginal vault prolapse. Corresponding to Petros even functional disorders like urinary urgency and nocturia are improved. The aim of this study was to report our experience with ICS. Methods: The infracoccygeal sacropexy was performed on 13 patients with vaginal vault prolapse and 8 with uterine prolapse and enterocele. Urodynamics preoperatively revealed urge incontinence (detrusor instability). The incontinence score was checked pre- and postoperatively with the Gaudenz questionnaire. Results: Preliminary results after 6 months revealed an improvement of urge incontinence in 16 out of 21 patients (76%). The non-responders (24%) to the ICS procedure - concerning relief of urge symptoms - had a history of hysterectomy and previous surgery in the anterior compartment. No recurrence of prolapse was observed. There were no severe intra- or postoperative complications. Conclusions: Infracoccygeal sacropexy is a new surgical procedure for restoration of vaginal vault and uterine prolapse. Additionally urinary urge incontinence is improving. Patients with scar tissue at the bladder neck as a consequence of previous surgery, have no benefit according to this study from ICS procedure in concern to relief of urge symptoms.