Vesicourethral anastomosis including rhabdosphincter in retropubic radical prostatectomy: Technique and results.

OBJECTIVE: Retropubic radical prostatectomy (RRP) is still widely used in clinical practice in localized prostate cancer because of its high oncological success. The aim of this study was to define the continence status in patients where rhabdosphincter was included in the vesicourethral anastomosis. MATERIALS AND METHODS: Between November 2004 and September 2010, 90 cases who underwent RRP by the same surgeon in our clinic were taken into the study. In all cases vesicourethral anastomosis was performed include the rhabdosphincter. The anastomosis was performed with mean 2.9 (0-7) interrupted no 2-0 vicryl sutures, depending on the angulation of symphysis pubis and pelvic cavity. Pad test was performed to all patients at 1, 3, 6 and 12 months postoperatively. We defined patients as 'continent' when they no need pad, as 'mild incontinence' when they use only one pad daily, as 'moderate incontinence' when they use two or three pads daily and as 'severe incontinence' when they use more than three pads daily. RESULTS: Preoperative total PSA value was 12.2 ng/ml (range: 2.7-84 ng/ml). Preoperative prostate biopsy results were found that Gleason scores were 5, 6, 7 and 8 in 7, 53, 21, 9 patients, respectively. Mean operation and urethral catheter removal time was 103 minutes (60-200) and 14,6 days (9-28), respectively. Mean hospital stay was 4.6 days (2-20). According to results of postoperative pad tests, 38 (42.2%), 48 (53.3%), 55 (61.1%) and 75 (83.3%) patients were defined as continent in first, third, sixth and twelfth months, respectively. CONCLUSIONS: We think that, our novel technique of vesicourethral anastomosis in standard RRP provides more optimal urethral position during fixation of pelvic floor and urethra, protect caudal retraction, preserve functional urethral length. Also strong full thickness stitch on urethra provides better urinary continence by hanging urethra in our patients. Although our early continence rate is better, our long term continence rate is similar to literature.

Turkish validation of the urethral stricture surgery specific patient-reported outcome measure (USS-PROM) with supplemental assessment of erectile function and morbidity due to oral graft harvesting.

AIMS: We validated a Turkish language version of the urethral stricture surgery specific patient-reported outcome measure (USS-PROM) in men undergoing anterior urethroplasty. We also investigated changes in erectile function (EF) and quality of life (QoL) due to oral mucosa graft (OMG) harvesting. METHODS: The USS-PROM captures lower urinary tract symptoms (LUTS), health related QoL (HRQoL) with EQ-5D visual analogue scale (EQ-VAS). To evaluate EF and OMG morbidity, we used International Index of Erectile Function (IIEF-5) and a self-completed questionnaire, respectively. Psychometric assessment of USS-PROM included test-retest reliability, internal consistency, criterion validity, and responsiveness. Objective evidence for urethroplasty success was demonstrated with fluoroscopic imaging and urethral calibration at post-operative six months. RESULTS: Among the 101 men included during study period, 42 had complete pre- and postoperative 6th month data for analysis. The test-retest intraclass correlation was 0.79. Cronbach's α for internal consistency of the LUTS construct was 0.79. There was a significant negative correlation between total LUTS scores and peak flow rates, both preoperatively (r = -0.478) and postoperatively (r = -0.508). Mean baseline EQ-VAS increased from 70 to 84 postoperatively (P < 0.001), indicating improved HRQoL. IIEF scores did not change significantly after urethroplasty. Early and late-term QoL impairment rates due to OMG harvesting were 28.9 and 13.1%, respectively. Three (7.1%) men required endoscopic intervention for recurrence within 6 months. CONCLUSIONS: Turkish version of USS-PROM showed comparable psychometric properties with the original version. Complementation of this instrument with additional measures that address sexual function and OMG morbidity provides better QoL assessment for urethral reconstruction.

Our experience in chordee without hypospadias: results of 102 cases.

PURPOSE: We present long-term surgical experience of 102 chordee without hypospadias cases. MATERIALS AND METHODS: This retrospective study included 102 chordee without hypospadias cases who were surgically treated between 1999 and 2012. Range of patients' age was from 1 month to 31 years. Seventy-two patients were adult, and 30 were children. Mean duration of follow up was 49.3 months. The patients were categorized into 4 groups including skin tethering (group 1), fibrotic dartos and Buck's fasciae ( group 2), corporeal disproportion ( group 3) and urethral tethering (group 4) with the aid of intraoperative artificial erection, according to the structural defect. RESULTS: Forty patients (group 1) were successfully treated with penile degloving. Except 3 (10%) of 31 (group 2) cases, extensive resection of the fibrotic dartos and Buck's fascia was needed to straighten the penis. Corporeal disproportion was identified in 27 patients of whom 2 cases (7%) had complica­tions. One of them developed urethrocutaneous fistula, and he was treated with buccal mucosal graft urethroplasty successfully. In other one, chordee persisted after two years, and we had to do Nesbit wedge resection after tunica albuginea plication to achieve penile straightening at the same session; otherwise we avoid tunica albuginea excision or incision. Overall 96 (94%) of 102 patients were suc­cessfully treated at first operation. CONCLUSION: We concluded that tunica albuginea plication is very effective for both prepubertal and postpubertal period and also in management of recurrence. We believe that, in experienced hands, early surgical correction can be done successfully in this condition.

Minimum 1-year results of mesh spiral-sling procedure in managing refractory and primary disabling stress urinary incontinence.

INTRODUCTION AND HYPOTHESIS: We present our minimum 1-year results with a mesh spiral-sling procedure (MSSP) for managing refractory and disabling stress urinary incontinence (SUI) in women. METHODS: Thirty-four women were treated with MSSP between 2007 and 2011. Six had incomplete data and were excluded from analysis. Study cohort comprised 21 women with refractory (mean number of previous surgeries 2.2; range 1-6) and seen with primary disabling SUI. All patients had marked intrinsic sphincter deficiency (ISD) with a Valsalva leak-point pressure (VLPP) <60 cm H2O. Preoperative workup included assessing the impact of voiding symptoms using the International Consultation on Incontinence Questionnaire--Short Form (ICIQ-SF), estimating the daily number of pads, and urodynamic studies. Preoperative and postoperative findings were compared using the Wilcoxon signed-rank test. RESULTS: Intraoperative unilateral bladder-neck perforation occurred in two women during dorsal urethrolysis. With a mean follow-up of 26 months (range 12-48), SUI was cured in 71.4% of patients. Distal urethral reconstruction with vaginal mucosal flaps was performed in two patients with short urethral length (<2.5 cm) due to recurrence of SUI 10 months after MSSP. Mean ICIQ-SF score decreased from 19.4 ± 3.6 preoperatively to 7.3 ± 2.8 postoperatively (p = 0.001). Mean daily pad number decreased from 5.2 preoperatively to 1.2 postoperatively (p = 0.02). Urethral or vaginal erosion was not observed in any case during follow-up. CONCLUSION: Using spiral slings may be a viable option in managing refractory and disabling SUI.

Laparoscopic decortication of hilar renal cysts using LigaSure.

BACKGROUND AND OBJECTIVES: In this study, we evaluated the safety and efficacy of using the LigaSure sealing system (Valleylab, Boulder, Colorado) for laparoscopic decortication of symptomatic hilar renal cysts. METHODS: Seventeen patients underwent laparoscopic decortication of hilar renal cysts with the LigaSure system. Our study included only symptomatic, Bosniak type 1, simple and symptomatic renal cysts. The operative route, transperitoneal or retroperitoneal, was planned according to the location confirmed by computed tomography. The patients' symptoms were preoperatively and postoperatively evaluated by the Wong-Baker visual pain scale. Operative measures and radiologic outcomes were prospectively evaluated. RESULTS: The mean age of the patients was 56.4 years, and the mean follow-up period was 12.5 months. Preoperative computed tomography showed only a single cyst in 15 patients (88.2%) and showed two separate cysts in 2 cases (11.8%). The cysts were located in the perihilar region close to the vascular structure in all patients. A transperitoneal approach was used in 9 patients, and a retroperitoneal approach was used in 8 patients. The mean operative time and hospitalization time were 56.4 minutes and 1.2 days, respectively. Minor complications were observed in 3 patients. Symptomatic and radiologic success rates of 94.2% and 100%, respectively, were achieved. CONCLUSION: Laparoscopic decortication of symptomatic hilar renal cysts--first reported in the literature in this study--using the LigaSure sealing system is feasible, effective, and safe, even if the cyst is located in the perihilar area.

Treatment of urethral strictures in balanitis xerotica obliterans (BXO) using circular buccal mucosal meatoplasy: experience of 15 cases.

OBJECTIVES: Balanitis xerotica obliterans (BXO) related strictures involving the external urethral meatus. We reviewed our result with the use of circular mucosal graft in the reconstruction of strictures. METHODS: Between March 1997 and January 2012, 15 patients underwent circular buccal mucosal urethroplasy for BXO related anterior urethral strictures. Urethral catheter was removed within 2 weeks. Follow-up included patient symptoms assessment, cosmetic outcome and uroflowmetry. RESULTS: Median follow-up was 20.5 months (range 4 to 96). Mean postoperative peak urinary flow rate obtained 1 month after catheter removal was 22.4 ml per second. All patients had a normal meatus and none had recurrent stricture, chordee or erectile dysfunction. A functional and cosmetic outcome was achieved in 100% of the patients. CONCLUSIONS: Circular mucosal graft technique for treatment of meatal strictures is an efficient method for the restoration of a functional and cosmetic penis.

Ventral inlay labia minora graft urethroplasty for the management of female urethral strictures.

OBJECTIVE: To evaluate the functional outcomes of ventral inlay labia minora graft urethroplasty (VILGU) for the management of female urethral strictures. METHODS: Data of 7 consecutive women treated with VILGU between 2011 and 2013 were reviewed. Two patients had cystostomy tubes at repair, and 5 had undergone previous urethral dilations and urethrotomies. Clinical evaluation included assessment of the effect of voiding symptoms with American Urological Association (AUA) symptom score, uroflowmetry, voiding cystourethrography, and intraoperative urethrocystoscopy using a 6.5F pediatric ureterorenoscope. Preoperative AUA symptom score and peak urinary flow rate were compared with postoperative values. Cure was defined as the absence of any restenosis requiring additional intervention with subjective patient satisfaction at the last follow-up. RESULTS: Mean stricture length was 1.5 cm (range, 1-2.5), and mean operative time was 95 minutes (range, 70-110). With a mean follow-up of 18.2 months (range, 3-30), cure was achieved in 6 (86%) women. At the last follow-up, mean maximum urine flow (mL/s) increased from 3.9 ± 3.1 preoperatively to 22.7 ± 8.3 postoperatively (P <.001), and mean AUA symptom score decreased from 25.3 ± 5.2 preoperatively to 6.9 ± 3.7 postoperatively (P = .001). No fistulae developed after surgery. "De-novo" stress urinary incontinence was not evident in any case. CONCLUSION: VILGU effectively provides better urinary flow and significantly improves patient satisfaction in patients with female urethral stricture disease.

Comparison of flexible and rigid cystoscopy-assisted ureteral catheter insertion before percutaneous nephrolithotomy: a prospective randomized trial.

BACKGROUND AND PURPOSE: To compare the advantages of flexible and rigid cystoscopy-assisted ureteral catheter placement before prone percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: From March to September 2012, a total of 80 patients with kidney stones underwent PCNL by the same surgical team. The patients were randomly assigned into one of the groups according to the technique used for ureteral catheter insertion: Flexible cystoscopy (group 1, n=40) or rigid cystoscopy (group 2, n=40). Patient demographics and operation-related factors were compared. The preparation period included positioning, cystoscopy-assisted stent insertion, and patient repositioning for PCNL. In addition, discomfort scores of the operating room (OR) staff were measured. RESULTS: The demographic values of the groups in terms of patient sex, age, body mass index, and stone size were comparable. While the mean preparation period was calculated as 9.9±2.3 minutes in the flexible cystoscopy group, it was significantly longer (19.7±2.9 minutes) in the rigid cystoscopy group (P<0.0001). In addition, the discomfort score of the OR staff was found to be significantly higher in the rigid cystoscopy group (1.1±0.9 vs 2.05±0.68, P<0.0001). The rest of the operative and postoperative parameters were similar. CONCLUSIONS: The insertion of a ureteral catheter with a flexible cystoscope before prone PCNL shortens the preparation period and minimizes the discomfort of OR staff related to patient positioning and transfer.

Ureteral quadruplication with three blind-ending branches.

A case of left-sided ureteral quadruplication with 3 blind-ending branches detected in a 16-year-old boy was presented by its step by step diagnostic work-up and treatment plan which is the first published case in the literature.

Micropercutaneous nephrolithotomy in the treatment of moderate-size renal calculi.

PURPOSE: We present our initial experience with microperc in patients with moderate-size renal calculi. PATIENTS AND METHODS: A retrospective analysis of 30 patients (male 14, female 16) with moderate-size (1-3 cm) kidney stones who underwent microperc between August 2011 and July 2012 was performed. The demographic values, perioperative and postoperative measures including age, stone size and location, body mass index, operative and fluoroscopy time, hemoglobin decrease, success and complication rates were prospectively recorded into a patient entry system. RESULTS: The average stone size was 17.9±5.0 mm (10-30 mm). The mean age of the patients was 41.5±18.2 years (range 3-69 years). The duration of the operation was calculated as 63.5±36.8 minutes (range 20-200 min). Mean fluoroscopic screening time was 150.5±90.4 seconds (range 45-360 seconds). The patients were discharged after a mean hospitalization period of 35.5±18.6 hours (range 14-96 hours). An overall success rate of 93% (including 10% of insignificant residual fragment rate) was achieved. In the follow-up, residual stone fragments were detected in two (7%) patients. Conversion to miniperc was necessitated in three (10%) patients. The mean hemoglobin drop was found to be 1.1±0.8 mg/dL (range 0-2.8 mg/dL). Complications were observed in five (13.3%) patients. CONCLUSIONS: Our initial results provide that microperc is a feasible, safe, and efficacious treatment modality for moderate-size kidney stones as well as small ones with its minimally invasive nature. Technical refinements are needed to achieve better results and overcome the limitations of technique.

Laparoscopic-assisted "microperc" of a stone in a pelvic kidney of a 3-year-old girl.

Treatment of kidney stones in pelvic ectopic kidneys of children is a challenging procedure for urologists. Herein we report a case of laparoscopy-assisted "microperc" in a 3-year-old girl with a stone in her pelvic ectopic kidney. This micro-optical system is helpful in confirming the percutaneous access and provides the possibility of fragmenting the stone without the necessity of dilating the tract.

Is fluoroscopic imaging mandatory for endoscopic treatment of ureteral stones?

OBJECTIVE: To present the feasibility and safety of fluoro-less endoscopic treatment of ureteral stones to diminish radiation exposure of the patient and operating team, and to determine circumstances where a fluoroscopic imaging is mandatory. METHODS: Between 2010 and 2011, 93 patients with ureteral calculi who underwent ureteroscopic treatment by experienced urologists were retrospectively evaluated. Manipulations, such as guidewire, ureteral stent insertion, and balloon dilatation were performed with visual and tactile cues. Patient demographics, need for fluoroscopic imaging, operation and fluoroscopy time, and complication and success rates were investigated. RESULTS: The mean age of patients was 34.03 ± 12.09 years (range, 9-63 years). The mean stone size was 10.64 ± 3.16 mm (range, 6-17 mm). The stones were localized in the proximal, middle, and distal segments in 11, 30, and 52 patients, respectively. The mean duration of the operation was 34.51 ± 7.94 minutes (range, 24-55 minutes). Stone-free status was achieved for 90 patients (96.77%). Fluoroscopic imaging was required for 7 patients with a mean fluoroscopy time of 9 ± 4.72 seconds (range, 4-16 seconds) for the following reasons: stone migration to the kidney (3 patients), double collecting system with 2 ureters (1 patient), and ureteral orifice stricture extending to the upper segment (1 patient). No major complications were observed, but minor complications were observed in 11 patients (11.8%). CONCLUSION: The ureteroscopic treatment of ureteral stones can be safely and effectively performed in experienced hands, with limited or no usage of fluoroscopy except in special circumstances, such as anatomic abnormalities, upper ureteral strictures, and impacted ureteral stones leading to ureteral tortuosity, kinking, and obstruction.

Review of extraperitoneal sacrocolpopexy as a technique for advanced uterine and vault prolapse.

PURPOSE OF REVIEW: This review is aimed to provide an update on the surgical techniques and complications of sacrocolpopexy procedures, and determine the role of minimally invasive techniques based on the most recent evidence. RECENT FINDINGS: The minimally invasive laparoscopic and robot-assisted alternatives to open abdominal sacrocolpopexy offer faster recovery, less complications and better cosmesis. However, this is suggested predominantly by retrospective comparative studies and no high-level evidence is available to date. Robot-assisted sacrocolpopexy (RASC) has enabled surgeons to overcome the steep learning curve associated with laparoscopic sacrocolpopexy at the expense of a higher cost. Recent data, testing its potential advantages of reduced operative time and postoperative pain, have revealed contradictory results. A novel, totally retroperitoneal sacrocolpopexy procedure aimed to eliminate complications associated with transperitoneal access may become an option in patients unsuitable for minimally invasive techniques, but warrants further investigation. SUMMARY: The benefits of RASC must be weighed against the lack of current evidence to prove its superiority over conventional procedures in terms of faster recovery and cost-effectiveness. There is a need for better reporting of complications associated with these novel techniques and for long-term, randomized comparative data.

Reconstruction of distal urethral strictures confined to the glans with circular buccal mucosa graft.

OBJECTIVE: To report our results with 1-stage reconstruction in short distal urethral strictures using circular buccal mucosa graft (cBMG). METHODS: The data of 19 patients (median age 41.8 years, range 25-58) operated between 2001 and 2010 were reviewed. Patients were evaluated with American Urological Association (AUA) symptom score, uroflowmetry, voiding cystourethrography (VCUG), and intraoperative urethroscopy. Stricture was limited to the glanular urethra (≤ 2 cm.) in all cases and 16 patients had lichen sclerosus. Strictured urethra was resected 0.5 cm proximal to the healthy urethra and a rectangular BMG with 4-cm length and 1.5- to 2.5-cm width (depending on the length of the defect) was rolled on a 24-Fr sound that calibrated the urethra. Proximal and distal edges of the cBMG were anastomosed circumferentially to the healthy mucosa and meatus, respectively. Foley catheter was removed within 10-14 days. Voiding symptoms, uroflowmetric parameters, and cosmesis were assessed at 1, 3, and 6 months, and yearly thereafter. RESULTS: With a median follow-up of 38 months (range 12-96), 16 (84.2%) patients were cured. One patient developed early graft loss, and 2 patients developed stricture at proximal anastomotic site. Mean Q(max) (mL/s) increased from 7.8 ± 5.4 preoperatively to 21.8 ± 9.2 postoperatively (P = .001), and mean AUA score decreased from 26.7 ± 3.9 preoperatively to 7.3 ± 3.8 postoperatively (P < .001). CONCLUSION: Our results suggest cBMG as a feasible alternative in 1-stage reconstruction of distal strictures confined to the glanular urethra because the glans penis has a good blood supply, providing an efficient circumferential graft take.

Impact of percutaneous renal access technique on outcomes of percutaneous nephrolithotomy.

BACKGROUND AND PURPOSE: Percutaneous nephrolithotomy (PCNL) is regarded as the gold standard for the treatment of patients with renal stones larger than 2 cm in diameter. Creating a percutaneous renal access is the initial and probably the most important step in performing a PCNL. Two primary methods of obtaining proper percutaneous renal access under fluoroscopic guidance are described: The "triangulation" and the "eye of the needle" techniques. In this article, we compare these two techniques in terms of success and complication rates. PATIENTS AND METHODS: From October 2010 to May 2011, 80 patients with simple renal stones were prospectively randomized into two groups according to the percutaneous renal access technique used for PCNL. Patients in group 1 (n=40) were assigned to the eye of the needle technique, and patients in group 2 (n=40) were assigned to the triangulation method. Patients needing multiple access points were excluded from the study. The preoperative, operative, and postoperative follow-up findings were thereafter analyzed and compared. RESULTS: No significant difference between the two groups was detected in terms of patient demographics (mean patient age, body mass index, stone size, or stone location). The operation time, fluoroscopic screening time (FST), and duration of hospitalization were similar in both groups (P=0.52, P=0.32, P=0.26, respectively). Patients in group 1 had a larger drop in hematocrit postoperatively than patients in group 2 (7.6 ± 3.7 vs 4.8 ± 2.1, P=0.001). The blood transfusion rate (7.5%) was similar in both groups, however. Although the complication rate was higher in group 1 than group 2, no significant difference was detected (20% vs 15%, P=0.76). CONCLUSIONS: The present study demonstrates that PCNL can be performed safely using two different percutaneous access techniques. The two techniques studied in this trial had similar FSTs, operation and hospitalization times, success rates, and complication rates.

A rare renal epithelial tumor: mucinous cystadenocarcinoma case report and review of the literature.

Primary renal mucinous cystadenocarcinoma is a very rare lesion of kidney which originates from the metaplasia of the renal pelvic uroepithelium. Only one case with primary mucinous cystadenocarcinoma has been reported in the English literature. We report second case of mucinous cystadenocarcinoma which was radiologically classified as type-IIF Bosniak cyst in peripheral localization. We aimed to present this extreme and unusual entity with its radiological, surgical, and pathologic aspects under the light of literature.

Rectovesical fistula related to transurethral resection of a bladder lesion.

A rectovesical fistula (RVF) is an uncommon complication of urooncologic surgery. Although several RVFs have been reported, our case is the first reported RVF in the literature that iatrogenically occurred after transurethral resection of the bladder. A single-stage primary repair with omental flap interposition without a colostomy was successfully performed because of the persistence of the fistula during followup. After 6 months of followup, no fistula or bladder mass was detected.

Rupture of superficial dorsal vein of penis.

Penile fracture is a remarkable but under reported urologic injury. Coitus and penile manipulations are common predisposing factors. Rupture of the superficial vein of penis is an uncommon situation that makes differential diagnosis with other penile lesions. The diagnosis in such cases is mostly after exploration. We report the cases of 34 and 49-year-old male patients with a painless hematoma after intercourse. Conservative or surgery intervention are the alternative mode of treatment.

Techniques and results of urethroplasty for female urethral strictures: our experience with 17 patients.

OBJECTIVES: To report our experience with urethroplasty in women with urethral stricture and discuss the therapeutic considerations and outcomes of various flap- and graft-based techniques. METHODS: A total of 17 patients with mid to distal urethral stricture (urethral caliber <14F, maximal urinary flow rate <12 mL/s, and detrusor pressure >20 cm H(2)O during voiding) underwent urethroplasty from 2004 to 2010. Of the 17 patients, 7 had undergone previous instrumentation and 10 were repaired primarily. The preoperative workup included American Urological Association symptom score assessment, uroflowmetry, voiding cystourethrography, and urethrocystoscopy. Of the 17 patients, 10 received anterior vaginal wall mucosa inlay urethroplasty. Proximally, the dilated urethral mucosa was used in 1 patient. A Martius flap reinforced ventral buccal mucosa graft (BMG) onlay urethroplasty was used in 2 patients with previous synthetic midurethral slings. Two patients with an atrophic vagina received a dorsal BMG onlay. A circular BMG reconstruction was used in 2 patients with severe distal urethral stricture. The preoperative findings were compared with the postoperative data at the last follow-up using the Wilcoxon sign test. RESULTS: With a median follow-up of 24 months (range 6-78), an objective and subjective cure was achieved in 17 (100%) and 15 (88%) patients, respectively. At the last follow-up, the mean maximal urinary flow rate increased from 10.8 ± 3.2 mL/s preoperatively to 28.9 ± 7.4 mL/s (P = .001), and the mean postvoid residual urine volume had decreased from 120 ± 30 mL preoperatively to 30 ± 12 mL (P = .001). The mean American Urological Association score had decreased from 27.1 ± 3.9 preoperatively to 7.1 ± 3.5 postoperatively (P < .0001). CONCLUSIONS: Primary urethroplasty can be considered a first-line option for treatment of female urethral strictures. Local mucosal flaps will cure the problem in most situations. BMG offers an excellent alternative when viable local tissue is absent.

A novel technique for the management of advanced uterine/vault prolapse: extraperitoneal sacrocolpopexy.

INTRODUCTION AND HYPOTHESIS: Abdominal sacrocolpopexy is the gold standard for advanced uterovaginal/cuff prolapse repair; however, early and late bowel complications are of concern. We report our experience with extraperitoneal sacrocolpopexy (ESCP). METHODS: Twenty-three patients who underwent ESCP between 2007 and 2010 were analyzed in this retrospective cohort study. Preoperative assessment included Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact (PFIQ-7) questionnaires, and pelvic examination according to Pelvic Organ Prolapse Quantification (POP-Q) system. Pre-operative findings were compared with postoperative values at the last follow-up using the Wilcoxon sign test. RESULTS: Mean operation time was 86 ± 20 min. Twenty patients were discharged within 24 h. With a mean follow-up of 20 months, objective and subjective cure rates were 91.3% and 86.9%, respectively. No postoperative complications were evident with significant improvement in POP-Q, PFDI-20, and PFIQ-7 scores. CONCLUSIONS: ESCP is a safe and effective sacrocolpopexy procedure that can potentially eliminate the risk of gastrointestinal complications.