Retropubic hysteropexy using a titanium mesh tape implant in patients with complicated stage III–IV apical prolapse

Abstract

Objective. To evaluate the efficacy and safety of a novel original surgical technique for the correction of moderate and severe complicated apical prolapse in pre- and postmenopausal women using a narrow titanium mesh tape implant (Titanell tape). Patients and methods. A total of 27 patients aged 54–82 years with complicated stage III–IV apical prolapse were examined and underwent surgery using the original technique with narrow titanium mesh tape implants. Complications included pressure ulcers (22.2%) and urinary retention (77.8%). Results. Follow-up assessments were performed at 1, 6, 12, and 24 months after surgery. A comparison of pre- and postoperative questionnaire scores showed an improvement in quality of life. During the first postoperative month, 22 (81.5%) patients reported intermittent pulling pain in the lower abdomen, perineum, and the right and left ilioinguinal regions, while 8 (29.6%) women experienced frequent urination. Comprehensive clinical monitoring confirmed that the surgical correction was maintained in all patients throughout the 24-month follow-up period. Gynecological and rectal examinations, as well as transperineal and transvaginal ultrasound, revealed no displacement of the pelvic organs or titanium mesh tape implants. No mesh-related complications were observed during the follow-up period. Conclusion. The present study demonstrated the efficacy and safety of the novel original surgical technique using a narrow titanium mesh tape implant for the correction of complicated stage III–IV apical prolapse in pre- and postmenopausal women. The advantages of this technique include minimization of the size and weight of the implant, as well as permanent hysteropexy achieved by durable artificial titanium ligaments. Key words: apical prolapse, retropubic hysteropexy, titanium mesh tape implant