“Classical” sacrocolpopexy as a method of surgical correction of apical genital prolapse

Pelvic organ prolapse (POP) in women is one of the most common gynecological diseases. According to various authors, the incidence of this pathology varies from 15 to 31.8%. Due to the introduction in a number of countries of restrictions on the use of synthetic implants for the correction of POP by vaginal access, as well as with a high risk of recurrence when strengthening the walls of the vagina with its own tissues, sacrocolpopexy has become the most preferred method of treatment for this disease. Objective. Evaluation of the results of the classical method of endoscopic access to sacrocolpopexy in patients with pelvic organ prolapse. Materials and methods. A single-center cohort non-randomized prospective study that included 40 patients with isolated or combined apical prolapse of the genitals of stage III-IV according to the classification of Pelvic Organ Prolapse—Q (quantitative assessment of the degree of pelvic organ prolapse), who underwent laparoscopic and robot-assisted access between 2021 and 2024 in the department of operative gynecology with oncogynecology and day care at the Moscow Regional Scientific Research Institute of Obstetrics and Gynecology named after Academician V.I. Krasnopolsky”. Results. The average period of postoperative follow-up of the patients was 12 months. Recurrence of POP was detected in 6 (15%) cases, among which 5 cases showed isolated prolapse of the anterior vaginal wall, and in one case, the posterior vaginal wall. At the same time, only two patients required repeated surgical correction of POP. There were no intraoperative complications or any mesh-associated complications in the early and late postoperative periods. Among 25 patients with diagnosed stress urinary incontinence, these symptoms persisted in 4 (16%), of whom 3 (12%) needed surgical correction. Clinically significant improvement in the quality of sexual life was noted in 36 (90%) patients. Conclusion. Concerning the absence of intraoperative as well as mesh-associated complications, the low frequency of repeated interventions due to recurrent POP, and a significant improvement in the quality of life of patients, classical sacrocolpopexy is the method of choice for surgical correction of apical prolapse. The frequency of the occurrence of the POP recurrence in the form of an isolated cystocele in patients with combined forms of the disease does not exclude the need to modify classical promontofixation by combining it with anterior colporraphy.