One-year outcomes of an innovative laparoscopic pectopexy procedure using inverted T-mesh for treatment of advanced uterine and anterior vaginal prolapse

Abstract This prospective pilot study was conducted to evaluate the safety and efficacy of an innovative laparoscopic pectopexy (LP) technique employing an inverted T-mesh for the concomitant treatment of advanced uterine and anterior vaginal prolapse. 42 patients (62.7%) underwent the innovative LP procedure, while 25 patients (37.3%) with predominant uterine or vaginal vault prolapse underwent conventional laparoscopic sacral hysteropexy or colpopexy (LS). The primary outcome was the anatomic outcomes and functional results. Secondary outcomes included surgical complications and reoperations. At baseline, the demographics of the LP group was younger, with lower body mass index (BMI), and were more sexually active when compared to the LS group (P < 0.05). At one-year follow-up, the anatomic cure rate (POP-Q stage < 2) was significantly lower in the LP group (78.6% [33/42] vs. 92.0% [23/25]; P = 0.0108). Functional outcomes were assessed using the PFDI-20, POPIQ-7 and PISQ-12 questionnaires, and significant improvements were observed in all domains. Multiple logistic regression revealed that the type of surgical procedure was not a significant predictor of outcome. Levator avulsion was the only variable significantly associated with poorer results (P < 0.05). Both groups demonstrated favorable postoperative outcomes, and had no severe surgical complications. Limitations of this study included non-randomization of the sample groups, small sample size and a follow-up time of one year. Despite these limitations, the findings suggest that the innovative LP procedure is a safe and feasible option for the concomitant management of advanced uterine and anterior vaginal prolapse. However, levator ani avulsion markedly increases the risk of anatomic recurrence. This study was registered on ClinicalTrials.gov (NCT07411898; 13/02/2026).