Universität zu Köln

Ludwig, Sebastian ORCID: 0000-0002-1627-1871, Pfleiderer, Mathieu ORCID: 0009-0003-3922-2049, Püchel, Jodok, Amir-Kabirian, Constanze, Jeschke, Janice, Ratiu, Dominik, Eichler, Christian, Morgenstern, Bernd ORCID: 0000-0002-5689-0079, Mallmann, Peter, Radosa, Julia and Thangarajah, Fabinshy ORCID: 0000-0002-1458-7303 (2025). Comparison of Open Abdominal and Laparoscopic Bilateral Uterosacral Ligament Replacement: A One-Year Follow-Up Study. Journal of Clinical Medicine, 14 (6). MDPI. ISSN 2077-0383

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Abstract

[Artikel-Nr. 1880] Background: Pelvic organ prolapse significantly affects women’s health, often requiring surgery. Unilateral sacrocolpopexy (SCP) is the gold standard for apical prolapse repair. However, varied SCP techniques can lead to inconsistencies in clinical outcomes, with differences in synthetic materials, mesh dimensions, placement, and apical tensioning. This variability may impact the comparability of clinical outcomes. Bilateral apical fixation has gained attention for its potential to provide effective apical support and restore anatomical integrity. Objective: To date there are not many studies on bilateral apical cervicosacropexy between the vaginal apex and the sacrum at the level of S1/promontory with one-year follow-up. Methods: This study presents a one-year follow-up comparing the clinical outcomes of open abdominal (CESA) and laparoscopic cervicosacropexy (laCESA) for bilateral apical suspension in women with pelvic floor disorders. A total of 145 women underwent either CESA (n = 75) or laCESA (n = 70) using a surgical technique with a designed polyvinylidene-fluoride (PVDF) mesh of defined shape replacing both uterosacral ligaments. Outcomes were efficacy, safety, and success rates of both surgical approaches in restoring apical vaginal support and pelvic floor functioning. Results: Both techniques demonstrated high efficacy of apical prolapse repair and a high level of safety. While comparable rates of urinary continence restoration were achieved, laCESA showed significant advantages in terms of operative time, hospital stay, and recovery time. Conclusions: These findings demonstrate the reproducibility of a surgical technique including clinical outcomes in the treatment of pelvic floor dysfunction. The standardization of mesh design and surgical methodology enhances reproducibility and may mitigate some of the variability associated with clinical outcomes in apical mesh fixation techniques.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Ludwig, Sebastian UNSPECIFIED https://orcid.org/0000-0002-1627-1871 UNSPECIFIED Pfleiderer, Mathieu UNSPECIFIED https://orcid.org/0009-0003-3922-2049 UNSPECIFIED Püchel, Jodok UNSPECIFIED UNSPECIFIED UNSPECIFIED Amir-Kabirian, Constanze UNSPECIFIED UNSPECIFIED UNSPECIFIED Jeschke, Janice UNSPECIFIED UNSPECIFIED UNSPECIFIED Ratiu, Dominik UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichler, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Morgenstern, Bernd UNSPECIFIED https://orcid.org/0000-0002-5689-0079 UNSPECIFIED Mallmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Radosa, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Thangarajah, Fabinshy UNSPECIFIED https://orcid.org/0000-0002-1458-7303 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-799897
Identification Number:	10.3390/jcm14061880
Journal or Publication Title:	Journal of Clinical Medicine
Volume:	14
Number:	6
Number of Pages:	18
Date:	11 March 2025
Publisher:	MDPI
ISSN:	2077-0383
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Frauenheilkunde > Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language pelvic organ prolapse ; pelvic floor dysfunction ; polyvinylidene fluoride ; urinary incontinence ; bilateral apical fixation ; bilateral cervicosacropexy ; bilateral sacropexy English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79989