Laparoscopic sacrocolpopexy with mesh fixation: a randomized trial comparing synthetic cyanoacrylate glue to sutures.

PURPOSE: To compare laparoscopic sacrocolpopexy using synthetic glue for mesh fixation to laparoscopic suturing in the treatment of pelvic organ prolapse. MATERIALS AND METHODS: This prospective randomized controlled trial included 54 patients with stage III or IV pelvic organ prolapse who underwent surgical correction and were allocated to two groups: a glue group which underwent laparoscopic sacrocolpopexy using synthetic cyanoacrylate glue for mesh fixation and a sutures group which underwent the same procedure using suturing for mesh fixation. Operative time, success rate, and perioperative complications were compared between the two groups. Patients were followed up at 1, 12, and 24 months postoperatively. RESULTS: The median operative time was 108.8 min [83.2-155.6] in the glue group and 111.4 min [90.2-186.2] in the sutures group, without significant difference between the groups. However, the time required for anterior mesh fixation was significantly lower in the glue group compared to the sutures group (4.6 min [0.5-29.6] vs. 25.4 min [1.7-44.7], p = 0.0001). The anatomical success rates ranged from 100 to 92.6% at 1 month postoperatively, and from 88.2 to 73.7% at 24 months in the glue and sutures groups, respectively, without statistically significant difference. CONCLUSIONS: The use of synthetic glue in laparoscopic sacrocolpopexy is a safe and effective alternative to suturing. However, larger studies with extended follow-up are required to further assess long-term efficacy and complication rates.