Background

Pelvic organ prolapse is a common condition that significantly impacts women's quality of life, especially in older age. Sacral colposuspension, or colpopexy, has been considered the surgical standard for its correction; however, it is associated with greater technical complexity, prolonged surgical time, and risks related to presacral dissection. In this context, pectopexy has emerged as an innovative surgical alternative that uses the iliopectineal ligament as an anchor point. 

Pectopexy avoids the risks associated with sacral dissection, and is an attractive option for limited resource environments. A recent review noted a lack of published data on the use of Pectopexy in such environments[1]. Pectopexy was recently introduced in Mexico by an international team including surgeons from both the US and Mexico, working in a small rural operating room with only basic laparoscopic equipment. 

Hypothesis: Pectopexy is feasible and safe in a low resource environment with only basic laparoscopic capabilities.

An observational, descriptive, and retrospective study was conducted on patients undergoing Pectopexy. Patients diagnosed with pelvic organ prolapse who underwent surgery during the study period were included. Sociodemographic (age, parity), clinical (main symptom, degree of prolapse according to the POP-Q classification), and surgical (operative time, estimated blood loss, intra- and postoperative complications, length of hospital stay, and anatomical results) variables were analyzed. Statistical analysis was descriptive; quantitative variables were expressed as mean and standard deviation or median, depending on the distribution, and qualitative variables as frequencies and percentages.

A total of 12 patients diagnosed with pelvic organ prolapse were included; the mean age was 64.2 years (±6.1). The main symptom was a sensation of a vaginal mass in most cases. Advanced grades of prolapse (POP-Q ≥ III) predominated. The average surgical time remained within expected ranges, with low intraoperative bleeding (<100 mL in most cases). No major complications were reported. The hospital stay was 2 days in all cases. At 1 and 3 months of follow-up, no recurrences or serious complications were observed.

Our initial results support our hypothesis that laparoscopic Pectopexy is safe and feasible in low resource environments with only basic laparoscopic capabilities.

These results may have significant implications for prolapse surgery in the developing world. Surgeons with basic laparoscopic skills, who may be reluctant to attempt sacrocolpopexy due to concerns about potential complications such as catastrophic hemorrhage, may wish to consider learning Pectopexy instead, as our initial results suggest that can be performed safely and effectively in low resource settings where only basic laparoscopic equipment is available.

Jongjakapun A, Temtanakitpaisan T, Sothornwit J, Pattanittum P, Ngamjarus C. Pectopexy for Pelvic Organ Prolapse: A Scoping Review. Int Urogynecol J. 2025 Dec;36(12):2337-2348. doi: 10.1007/s00192-025-06232-9. Epub 2025 Jul 16. PMID: 40668393.