Laparoscopic bilateral subperitoneal correction of apical prolapse with titanium mesh implants
Objective. To study the efficacy and to assess the safety of the use of titanium ribbon-like implants for surgical correction of various forms of apical prolapse. Patients and methods. 23 patients with apical prolapse (stage III-IV) aged 29 to 74 years were examined. Surgical correction of various forms of apical prolapse was performed using titanium ribbon-like mesh implants, which are more inert to the surrounding tissues than polypropylene scaffold systems. Dynamic outpatient observation of the patients was carried out after 3, 6, 12, 15 months after surgery. Results. The duration of surgery varied from 55 to 80 minutes, on average 74 ± 11.5 minutes. Intraoperative blood loss ranged from 50 to 150 mL (100 ± 35.7 mL). Of the early postoperative complications, only hematomas in the projection of the posterior vaginal wall of small sizes (up to 10 ml) - 2 (8.7%) were noted. Comparison of the questionnaire data from patients in the pre-and postoperative period showed an improvement in the quality of life of patients, an increase in their social and sexual activity. There was no significant displacement of the pelvic organs, and there were no mesh-associated complications. Conclusion. Laparoscopic bilateral subperitoneal hystero-, cervico-, colposuspension to the aponeurosis using titanium mesh ribbon-like implants improves the efficiency of surgical treatment of various forms and severity of apical prolapse.