Akademik Veri Yönetim Sistemi
International Urogynecology Journal, 2025 (SCI-Expanded)
Introduction and Hypothesis: To compare the outcomes of laparoscopic pectopexy (LP) with uterine preservation between mesh placement anterior to the cervix uteri and mesh placement posterior to the cervix uteri. Methods: A retrospective cohort study of 72 women who underwent LP for stage III or IV apical pelvic organ prolapse (POP) was conducted: 48 with mesh placement anterior to the cervix (group I) and 24 with mesh placement posterior to the cervix (group II). The primary outcome was the rate of postoperative recurrences in both groups. The secondary outcome was the change in quality of life, as evaluated by comparing the results of the prolapse quality of life (P-QOL) questionnaire completed pre- and postoperatively. Results: The mean age (58.27 ± 9.85 vs 59.04 ± 9.93 years; p = 0698) and mean follow-up period (24.85 ± 5.12 vs 23.17 ± 6.93 months; p = 0.323) were similar between the groups. Demographic characteristics and operative time (73.23 ± 14.10 vs 77.08 ± 29.52 min, p = 0.407) were similar between the groups. No intraoperative or postoperative complications were noted in any of the groups. Recurrence (12.5% vs 8.3%, p = 0.710) and reoperation rates (4.2% vs 8.3%, p = 0.597) did not differ significantly between the groups. When the pre- and postoperative changes in the P-QOL questionnaire scores were compared between the two groups, the positive change in POP symptoms, sleep/energy, severity of symptoms and total scale score was more significant in group I. Other scale scores were similar between the two groups. In regression analysis, preoperative Ba, D, Ap and Bp points were found to be significant predictors. An increase in Ba and Ap values increased the likelihood of posterior mesh placement, while an increase in D and Bp values increased the likelihood of anterior mesh placement. Conclusions: In laparoscopic pectopexy, placing the mesh anterior or posterior to the cervix has similar results.