Hybrid pelvic floor reconstruction using a vaginal flap with unilateral apical fixation in the management of post-hysterectomy prolapse: A retrospective study

Aim. To evaluate the anatomical effectiveness and safety of hybrid pelvic floor reconstruction using a vaginal flap with unilateral apical fixation in women with post-hysterectomy prolapse.

Materials and methods. This retrospective study included 62 female patients with stage II–IV vaginal vault prolapse (according to the POP-Q classification) who underwent a novel surgical technique. The primary endpoint was anatomical success; secondary endpoints included changes in quality of life (PFDI-20, ICIQ-SF questionnaires) and patient satisfaction with treatment outcomes.

Results. The mean follow-up period was 14.86 months. Anatomical success was achieved in 93.5% of cases. No cases of implant erosion or chronic pelvic pain were reported. Significant improvement in pelvic floor dysfunction symptoms was observed across all PFDI-20 subscales (p<0.001). Vaginal length significantly increased postoperatively. Recurrence of prolapse occurred in 6.5% of cases and required reoperation. Two cases of intraoperative bladder injury were noted, which did not affect the final outcomes.

Conclusion. Hybrid pelvic floor reconstruction using a vaginal flap with unilateral apical fixation demonstrated high anatomical efficacy and safety in the correction of post-hysterectomy prolapse. However, further prospective studies with control groups and longer follow-up are needed to confirm these findings.