• Posted November 18, 2024

New Prolapse Surgery Uses Women's Own Tissues to Restore Function

It’s possible to correct a woman’s pelvic prolapse using her own muscle tissue in robot-assisted surgery, a new study demonstrates.

In the procedure, tendon muscle is transferred from the thigh to the uterus or cervix, repairing a pelvic floor that’s become weakened and is allowing organs to press into each other, researchers explained.

The newly developed procedure successfully corrected prolapse in the first 10 female patients, the team reported Nov. 12 in the International Urogynecology Journal.

"This pilot study shows excellent clinical outcomes, with an improved quality of life for the patients," said senior researcher Dr. Dominique Konsgen-Mustea, head of urogyenecology at University Hospital Bonn in Germany.

With pelvic prolapse, the pelvic floor muscles weaken to the point that one or more organs -- the bladder, uterus, urethra or rectum -- start pressing into the vagina. Symptoms can include difficult urination, urinary tract infections, painful sex and constipation.

Pelvic prolapse typically occurs after pregnancy and childbirth, researchers said in background notes. Aging, excess weight and conditions that cause frequent coughing also increase a woman’s risk of pelvic prolapse.

Surgery can correct a prolapse, typically by implanting a synthetic mesh fabric that reinforces the pelvic floor, researchers said.

But using a person’s own muscle, taken from elsewhere in the body, could work even better than the synthetic mesh, doctors reasoned.

In the new procedure, researchers make a small incision in the back of the knee and remove part of the thigh tendon. The tendon is then implanted into the pelvic floor.

"The advantage of this method is that no foreign material enters the body," Konsgen-Mustea said in a university news release. "And removing the tendon also has no negative effects on the leg: it remains pain-free and, in the long term, unrestricted in terms of mobility."

Doctors performed the first robot-assisted pelvic prolapse surgery in June 2022, and had carried out the first 10 by February 2023, researchers said.

All 10 patients had positive outcomes a year after their surgery, researchers said. None suffered another prolapse, and there were no complications from the surgery.

"With the DaVinci robot, we have a highly magnified 3D-image and can therefore perform the surgery very precisely,” Konsgen-Mustea said. “This makes the procedure tissue-sparing and bleeding-less, and we can easily reach all deep compartments of the pelvic floor.”

More information

Harvard Medical School has more on pelvic organ prolapse.

SOURCE: University Hospital Bonn, news release, Nov. 13, 2024