Vaginal axis on MRI after laparoscopic lateral mesh suspension surgery: a controlled study

Introduction and hypothesis Laparoscopic lateral mesh suspension (LLMS) has emerged as a practical, safe, and feasible alternative to sacrocolpopexy (SCP) for treating female genital apical prolapse. Although several prior studies have reported changes in the vaginal axis in women who have undergone SCP or sacrospinous ligament fixation (SSLF) surgery for prolapse, there is a lack of data on changes in the vaginal axis after LLMS. This study was aimed at investigating the level of anatomical correction following LLMS and comparing the vaginal axis on magnetic resonance imaging (MRI) in patients with apical genital prolapse. Methods Patients who underwent LLMS and a nulliparous control group were included in this observational prospective case–control study. MRI was performed on the control group and the study group pre- and postoperatively. The angle between the pubococcygeal line and the lower vaginal segment, the angle between the levator plate and the pubococcygeal line, and the angle between the lower and upper vaginal segments were measured and compared. Results The angles measured between the pubococcygeal line and the lower vaginal segment and between the levator plate and the pubococcygeal line were significantly lower in the preoperative than in the postoperative measurements ( p