Surgical correction of multicompartment pelvic organ prolapse using titanium ligatures

Abstract

Objective. To evaluate the efficacy and safety of an original surgical technique for the treatment of patients with stage II–III multicompartment pelvic organ prolapse (POP) using titanium ligatures and native tissues. Patients and methods. The study included 22 patients aged 38–56 years with multicompartment POP (stage II–III apical prolapse, anterior and/or posterior vaginal wall prolapse, and pelvic floor dysfunction). All patients underwent surgery using the original technique with titanium sutures and native tissues. Results. Postoperative outpatient follow-up was performed at 1, 6, 12, and 24 months. Patient-reported questionnaires indicated improved quality of life. During the first postoperative month, 14 (63.6%) women reported intermittent dull pain in the lower abdomen, perineum, and ilioinguinal region, while 31.8% reported frequent urination. Dynamic follow-up revealed sustained positive surgical outcomes over 24 months. Transperineal and transvaginal ultrasound showed no postoperative displacement of pelvic organs, and no mesh-related complications were observed. Conclusion. The study demonstrated the efficacy and safety of the novel surgical technique for the treatment of multicompartment POP using a combined approach with titanium ligatures for hysterosuspension in reproductive-aged and premenopausal women. The absence of pelvic organ displacement and mesh-related complications in both early and late postoperative periods resulted in improved quality of life and restored sexual activity. The developed technique offers clear advantages over other methods due to the minimal mass and volume of implanted material, permanent uterine suspension using artificial supporting “ligaments”, and simultaneous correction of anterior and/or posterior prolapse and pelvic floor dysfunction. Key words: pelvic organ prolapse, titanium ligatures, hysterosuspension