Application of the Dual-Axis Theory in the Management of Multicompartment Pelvic Organ Prolapse: Experience from Eight Cases

Background & Objective: Pelvic organ stability is maintained by two principal axes: the anterior perineal suspension axis (APSA) and the posterior perineal suspension axis (PPSA). Concomitant impairment of both axes results in multicompartment pelvic organ prolapse (MC‑POP), a complex condition that significantly affects quality of life. The laparoscopic dual‑axis fixation (LADAF) technique was developed to restore both axes simultaneously, aiming to provide a physiological and comprehensive reconstruction of the pelvic floor. To evaluate the early outcomes of LADAF in the treatment of MC-POP. Materials & Methods: A retrospective descriptive case series was conducted on patients with MC-POP who underwent LADAF at Hanoi Medical University Hospital between January ۲۰۲۰ and June ۲۰۲۵. Results: The mean operative time was ۱۳۲.۵ minutes, and the average hospital stay was ۴.۱۱ days. One intraoperative complication, involving a tear of the rectal muscularis–serosal layer, was recorded. Postoperative complications included one case of urinary retention and one case of constipation, both of which resolved with conservative treatment. A marked improvement was observed in prolapse severity across all three pelvic compartments. The mean Pelvic Floor Distress Inventory-۲۰ (PFDI-۲۰) score decreased from ۱۷۱.۶۶ to ۱۲.۸۹, and the Pelvic Floor Impact Questionnaire-۷ (PFIQ-۷) score decreased from ۱۵۲.۵ to ۲۵.۵۵. No recurrence was noted during a mean follow-up of ۲۷.۵ months. Conclusion: LADAF is a safe and effective laparoscopic approach for MC-POP, providing physiological restoration of pelvic support structures and significant improvement in quality of life. Further studies with larger sample sizes and longer follow-up are required to confirm its long-term durability.

کلیدواژه ها:

Multicompartment pelvic organ prolapse ، Posterior perineal suspension axis ، anterior perineal suspension axis ، Laparoscopic dual-axis fixation ، dual-axis theory