Pitsillidi Anna, Grigoriadis Georgios, Vona Laura, Noé Guenter, Daniilidis Angelos
Department of OB/GYN, Rheinland Klinikum Neuss, Preußenstrasse 84, 41464 Neuss, Germany.
1st University Department in Obstetrics and Gynecology, Papageorgiou General Hospital, School of Medicine, Aristotle University of Thessaloniki, 546 43 Thessaloniki, Greece.
J Clin Med. 2025 Sep 7;14(17):6318. doi: 10.3390/jcm14176318.
Pelvic organ prolapse (POP) significantly impairs patients' quality of life, especially in urinary, bowel, and sexual domains. While laparoscopic sacrocolpopexy (LS) is the current gold standard for apical prolapse repair, it is associated with certain complications. Laparoscopic pectopexy (LP), a newer technique utilizing the iliopectineal ligament for apical suspension, may offer improved outcomes with fewer adverse effects. This scoping review aimed to evaluate patient-reported outcomes (PROs) and quality of life (QoL) following LP and compare its effectiveness to other established surgical approaches. A scoping review was conducted in accordance with PRISMA-ScR guidelines. Searches of PubMed, Scopus, and Web of Science databases were performed through June 2025. Eligible studies included randomized controlled trials, prospective and retrospective cohorts, and case series that reported PROs following LP. Data on validated QoL tools (e.g., P-QOL, PFDI-20, PFIQ-7, FSFI, PISQ-12), surgical technique, and follow-up duration were extracted. Due to heterogeneity in the study design and outcomes, findings were synthesized qualitatively. Thirteen studies including a total of 742 patients met the inclusion criteria. Across all included studies, LP was associated with significant improvements in QoL metrics, including urinary and sexual function, and overall patient satisfaction. Tools such as PFDI-20, FSFI, PISQ-12, and PGI-I consistently showed postoperative improvement ( < 0.05). Comparative studies demonstrated that the outcomes for LP were similar or superior to those of sacrocolpopexy, sacrospinous fixation, or sacrohysteropexy, particularly regarding sexual function. LP is an effective surgical alternative for apical POP repair, offering significant improvements in patient-reported quality of life and functional outcomes. Its favorable safety profile and comparable efficacy to traditional methods make it a compelling option, particularly for patients with contraindications to sacral dissection. Findings are limited by small and heterogeneous studies, short follow-up, and potential publication and language biases. Further prospective studies with long-term follow-up periods are necessary to confirm these findings and refine patient selection criteria.
盆腔器官脱垂（POP）严重损害患者的生活质量，尤其是在泌尿、肠道和性功能方面。虽然腹腔镜骶骨阴道固定术（LS）是目前治疗顶端脱垂的金标准，但它会引发某些并发症。腹腔镜耻骨固定术（LP）是一种利用髂耻韧带进行顶端悬吊的新技术，可能会带来更好的治疗效果且副作用更少。本综述旨在评估LP术后患者报告结局（PROs）和生活质量（QoL），并将其有效性与其他已确立的手术方法进行比较。按照PRISMA-ScR指南进行了一项综述。截至2025年6月，对PubMed、Scopus和科学网数据库进行了检索。符合条件的研究包括随机对照试验、前瞻性和回顾性队列研究以及报告LP术后PROs的病例系列。提取了关于经过验证的QoL工具（如P-QOL、PFDI-20、PFIQ-7、FSFI、PISQ-12）、手术技术和随访时间的数据。由于研究设计和结局存在异质性，对研究结果进行了定性综合分析。13项研究共纳入742例患者，符合纳入标准。在所有纳入研究中，LP与QoL指标的显著改善相关，包括泌尿和性功能以及患者总体满意度。PFDI-20、FSFI、PISQ-12和PGI-I等工具始终显示术后有所改善（P<0.05）。比较研究表明，LP的结局与骶骨阴道固定术、骶棘肌固定术或骶骨子宫固定术相似或更优，尤其是在性功能方面。LP是治疗顶端POP的一种有效手术替代方法，能显著改善患者报告的生活质量和功能结局。其良好的安全性以及与传统方法相当的疗效使其成为一个有吸引力的选择，特别是对于有骶骨解剖禁忌证的患者。研究结果受到研究规模小且异质性大、随访时间短以及潜在的发表和语言偏倚的限制。需要进一步进行长期随访的前瞻性研究来证实这些发现并完善患者选择标准。
