Tissue fixation system (TFS) to repair uterovaginal prolapse with uterine preservation: a preliminary report on perioperative complications and safety

Objectives: To assess the effectiveness, perioperative safety and invasiveness of the Tissue Fixation System (TFS) sling operation when used for repair of uterovaginal prolapse with uterine preservation. Methods: Operations using the TFS anchor system were performed on 25 women aged between 44 and 84 years (average 65) for grade 3 or 4 uterine prolapse with or without urinary incontinence. Details of the procedures were as follows: midurethral sling (n = 2); posterior sling of the uterosacral ligaments (n = 25); U-sling for lateral/central anterior vaginal wall defects (n = 24). The defect of the perineal body and rectovaginal fascia were repaired in all cases. Results: All patients were followed up for a minimum of 3 months. The mean ± standard deviation of the operating time and loss of blood were 94.2 (±19.3) minutes and 98.1 (±129.6) mL, respectively. Twelve patients (48%) were discharged on the same day of surgery and 13 patients (52%) on the following day, with a return to normal activities within 1–7 days. There were no intra- or postoperative complications. At the 3-month follow up, cure rates of symptoms due to pelvic laxity were: urinary frequency 85.7% (n = 14); nocturia 66.6% (n = 12); urgency 93.3% (n = 15); and dragging pain 100% (n = 6). There was one recurrent uterovaginal prolapse and one recurrent cystocele. Conclusion: The TFS procedure delivers satisfactory results for uterine prolapse repair with uterine preservation. The procedure is useful because of the short duration of the operation, the short term of recovery, its safety profile and minimal invasiveness. There is a significant improvement in the quality of life, especially for older women. However, long-term results are currently unknown.