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Pilsner Modification of Mesh Sacrohysterocolpopexy (PiMMS): An Initial Report on Safety and Efficacy

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Abstract

Introduction and hypothesis

It is reported that up to 60% of women would prefer to spare their uterus during pelvic organ prolapse (POP) repair surgery. A reliable hysteropexy technique is therefore crucial. We aimed to describe the safety profile and initial core patient-reported and clinical outcomes of the Pilsner modification of laparoscopic mesh sacrohysterocolpopexy (PiMMS) in comparison with the laparoscopic sacrohysterocolpopexy technique (standard laparoscopic sacrohysterocolpopexy [sLSH]) previously used in our unit.

Methods

This was a retrospective cohort study conducted in a single tertiary referral urogynecological center. All patients who underwent laparoscopic mesh sacrohysterocolpopexy between 1 January 2015, and 31 January 2022 were included in the study. Follow-up clinical, patient-reported, and imaging outcomes at the 12-month follow-up time point are presented.

Results

A total of 87 patients were included. Of these, 49 (56.3%) and 38 (43.7%) underwent sLSH and PiMMS respectively. Low numbers of perioperative complications were found in both groups with no mesh-related complications reported following PiMMS up to 12 months postoperatively. There were no apical compartment failures in either group. There were 8 (17.0%) vs 1 (2.7%) anterior compartment failures (Ba ≤ −1) in the sLSH and PiMMS groups respectively (p = 0.07) at 12 months. At the 1-year follow-up, 42 (89.4%) patients reported a Patient Global Impression of Improvement score of ≤ 2 in the sLSH groups compared with 35 (94.6%) patients following PiMMS.

Conclusions

The PiMMS technique seems to have comparable safety profile and patient-reported outcomes with the sLSH technique. However, there is a trend toward reduced anterior compartment failures with this modification. The findings of this preliminary report need to be re-evaluated in a well-powered prospective study.

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Data Availability

Data can be made available upon a reasonable request from the corresponding author.

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Funding

This work was funded by Charles University, Cooperatio Program, research area Maternal and Childhood Care through CoOperatio Uro-Gynecology for Applied Research (COUGAR). The funders did not have a role in the collection, analysis and interpretation of data and in the writing of the manuscript.

Author information

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Faculty Hospital, Trenčín, Slovakia

    Matej Vidoman

  2. Department of Gynecology and Obstetrics, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 76, 304 60, Pilsen, Czechia

    Matej Vidoman, Vladimir Kalis, Martin Smazinka, Martin Havir, Zdenek Rusavy & Khaled M. Ismail

  3. Department of Gynecology and Obstetrics, University Hospital, Pilsen, Czechia

    Vladimir Kalis, Martin Smazinka, Martin Havir & Zdenek Rusavy

  4. Center for Pelvic-Floor Disorders, Pilsen, Czechia

    Vladimir Kalis, Martin Smazinka, Martin Havir & Zdenek Rusavy

  5. Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czechia

    Khaled M. Ismail

Authors
  1. Matej Vidoman
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  2. Vladimir Kalis
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  3. Martin Smazinka
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  4. Martin Havir
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  5. Zdenek Rusavy
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  6. Khaled M. Ismail
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Contributions

M.V.: data collocation, data analysis, manuscript writing; V.K., M.S., M.H., Z.R.: patient recruitment, data interpretation, manuscript editing; K.I.: data analysis, data interpretation, manuscript editing.

Corresponding author

Correspondence to Khaled M. Ismail.

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Ethical Approval

Data collection and analysis of our unit’s urogynecological database for research purposes was approved by the University Hospital of Pilsen ethics committee (ref. 2392020).

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Handling Editor: Catherine Matthews

Editor in Chief: Maria A. Bortolini

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Vidoman, M., Kalis, V., Smazinka, M. et al. Pilsner Modification of Mesh Sacrohysterocolpopexy (PiMMS): An Initial Report on Safety and Efficacy. Int Urogynecol J (2024). https://doi.org/10.1007/s00192-024-05780-w

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