Meryem BEKMEZCİ, Ramazan BÜLBÜL, Şerife Özlem GENÇ
Pelviperineology - 2026;45(2):79-85
Objective: Pelvic organ prolapse (POP) is a common condition affecting pelvic floor support. It often leads to significant difficulties in daily activities and reduces patients' quality of life. Different surgical methods, such as laparoscopic lateral suspension (LLS) and vaginal natural orifice transluminal endoscopic surgery (vNOTES)-assisted lateral suspension, have become increasingly popular. This study aimed to evaluate early anatomical outcomes, measure intraoperative performance, and monitor postoperative complications in patients undergoing laparoscopic or vNOTES-assisted lateral suspension for anterior and/or apical POP. Materials and Methods: This retrospective study included 29 patients who underwent LLS for anterior and/or apical POP between January 2023 and May 2026. Demographic characteristics, prolapse stages, surgical data, perioperative outcomes, and follow-up findings were evaluated. The primary endpoint was defined as anatomical success. Factors influencing anatomical success were also analyzed. Results: The mean age of the patients was 49.7+/-9.9 years, and the mean body mass index was 27.3+/-2.8 kg/m². 72.4% of patients underwent vNOTES-assisted lateral suspension, while 27.6% underwent conventional LLS. The mean operation time was 110.5+/-44.1 minutes. No intraoperative or major postoperative complications were observed. The mesh-related complication rate was 20.7%. At the last follow-up evaluation, anatomical success was achieved in 22 patients (75.9%). The recurrence rate was 17.2%, and the rate of re-operation was 24.1%. Preoperative POP-Q stage was significantly higher in patients who developed anatomical failure (p=0.010). Advanced prolapse (POP-Q >=3) was associated with anatomical failure (p=0.035) and the need for re-operation (OR=10.5; p=0.035) (p=0.020). Conclusion: Laparoscopic and vNOTES-assisted lateral suspension are feasible and safe methods for treating anterior and apical POP. Advanced prolapse and prolonged operation time appear to be risk factors for anatomical failure. Studies with larger sample sizes and longer follow-up periods are needed.
