Patient-Reported Outcomes and Quality of Life After Laparoscopic Pectopexy

腹腔镜下耻骨固定术后患者报告结局和生活质量

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Abstract

Background: 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. Methods: 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. Results: 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 (p < 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. Conclusions: 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.

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