ArticleAnnals of Saudi medicine
Fascial fixation versus non-fixation in vNOTES lateral suspension after vaginal hysterectomy for pelvic organ prolapse.
Article in Annals of Saudi medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMesh-based vNOTES lateral suspension is an emerging minimally invasive technique for apical pelvic organ prolapse repair, but the clinical value of fascial fixation of the lateral mesh arms remains unclear.
objectivesTo compare 12-month anatomical outcomes and recurrence rates between fascial fixation and non-fixation of the lateral mesh arms during mesh-based vNOTES lateral suspension after vaginal hysterectomy.
designRetrospective comparative study. SETTINGS: Tertiary referral center. PATIENTS AND
methodsWe reviewed women who underwent vaginal hysterectomy combined with mesh-based vNOTES lateral suspension for pelvic organ prolapse between March 2022 and March 2026. Patients were grouped according to whether the lateral mesh arms were fixed to the fascia. Preoperative and 12-month postoperative Pelvic Organ Prolapse Quantification (POP-Q) measurements, recurrence, perioperative outcomes, postoperative complications, and mesh erosion were evaluated.
main outcome measuresThe primary outcome was recurrence at 12 months, defined as POP-Q point C >-1 cm, reflecting clinically significant apical prolapse. Secondary outcomes included POP-Q values and change scores, operative time, estimated blood loss, length of hospital stay, complications, and mesh erosion. SAMPLE SIZE: 101 patients; 46 in the non-fixation group and 55 in the fixation group.
resultsBoth groups demonstrated significant improvement in all evaluated POP-Q points at 12 months compared with baseline (
conclusionsFascial fixation of the lateral mesh arms was not associated with improved short-term anatomical, perioperative, or postoperative outcomes at 12 months following mesh-based vNOTES lateral suspension after vaginal hysterectomy. LIMITATIONS: Retrospective design, single-center setting, modest sample size, and 12-month follow-up period.
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