Fascial fixation versus non-fixation in vNOTES lateral suspension after vaginal hysterectomy for pelvic organ prolapse.

Authors

Havva Betül Bacak, Enes Serhat Coşkun, Serkan Kumbasar, Hayat Terkan, Pelin Pınar, Aybüke Bulut, Batuhan Bulut, Fatih İrice, Barışcan Aldanmaz, Sinem Deligözoğlu, Süleyman Salman

Published in

Annals of Saudi medicine. Volume 46. Issue 5. Pages 311-318. Epub Oct 01, 2026.

Abstract

Mesh-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.
To 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.
Retrospective comparative study.
Tertiary referral center.
We 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.
The 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.
101 patients; 46 in the non-fixation group and 55 in the fixation group.
Both groups demonstrated significant improvement in all evaluated POP-Q points at 12 months compared with baseline (P<.001). Recurrence occurred in four patients (8.7%) in the non-fixation group and four patients (7.3%) in the fixation group (P=1.0). Operative time, estimated blood loss, and length of hospital stay were comparable between groups (P=.347, P=.187, and P=.274, respectively). Similarly, no significant between-group differences were observed in perioperative complications (P=.59), postoperative complications (P=.426), or mesh erosion (P=1.0).
Fascial 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.
Retrospective design, single-center setting, modest sample size, and 12-month follow-up period.

PMID:
42829459
Bibliographic data and abstract were imported from PubMed on 04 Oct 2026.

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