Site-specific correction of urogenital prolapse with bilateral sacrospinous hysteropexy versus pelvic floor reconstruction with the six-armed mesh implant: two-year follow-up results

Aim: to compare the anatomical and functional outcomes of site-specific correction of anterior-apical prolapse using bilateral sacrospinous hysteropexy versus correction of prolapse using the six-armed OPUR® mesh implant. Materials and Patients: a total of 158 patients (mean age: 63 years) with stage II–III anterior-apical prolapse according to the Pelvic Organ Prolapse Quantification System (POP-Q) were included in this study. Site-specific prolapse correction with bilateral sacrospinous hysteropexy was performed in 82 patients (group I), while 76 patients received pelvic organ prolapse (POP) correction using the six-armed mesh implant (group II). All patients underwent gynecological examination and prolapse staging prior to surgery, and at 1, 3, 6, and 12 months, as well as annually thereafter The primary endpoint was the rate of prolapse recurrence after surgical treatment Secondary endpoints included the rate of peri- and postoperative complications, chronic pelvic pain, assessment of urinary and sexual function. Results: at 6 and 8 months, prolapse recurrence (hysteroptosis) developed in 2 (2.4%) patients in group I, and recurrent cystocele was observed in 1 (1.2%) of them. In group II, recurrence of uterine prolapse was detected in 2 (2.6%) patients at 6 months after surgery, and recurrent cystocele was observed at 23 months postoperatively. De novo continence was achieved in 19 (52.8%) of 36 patients with prior stress urinary incontinence. Meanwhile, de novo incontinence was diagnosed in 24 (15.2%) of all study participants. Obstructive urination resolved in 100% of cases; urgent urination persisted in 15 (9.4%) patients. Conclusion: both techniques are equally effective in eliminating defects of the anterior and apical pelvic fascia, reliably correcting cystocele and uterine prolapse Bilateral sacrospinous hysteropexy with pelvic fascia reconstruction enables reduction of the amount of mesh implant used, while "notorious" mesh-related complications were not observed with either technique. KEYWORDS: urogenital prolapse, site-specific correction, mesh implant, bilateral sacrospinous hysteropexy. FOR CITATION: Shpikina A.D., Enikeev M.E., Snurnitsyna O.V., Burakova L.I., Babaevskaya D.I., Abdurashitova V.Sh., Slobodyanyuk B.A., Dobrokhotova Yu.E., Nikitin A.N., Rapoport L.M. Site-specific correction of urogenital prolapse with bilateral sacrospinous hysteropexy versus pelvic floor reconstruction with the six-armed mesh implant: two-year follow-up results. Russian Medical Inquiry. 2025;9(4):241–248 (in Russ.). DOI: 10.32364/2587-6821-2025-9-4-9