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Promontofixation using titanium implant in patients with polyvalent allergy and combined gynecologic pathology

Clinical observation of two patients with polyvalent allergy, uterine leiomyoma, and stage II apical prolapse who underwent a combined surgical intervention of subtotal/total hysterectomy followed by cervical stump/vaginal stump promontofixation using titanium mesh implants. Dynamic follow-up for 3–12 months after surgery showed the absence of pelvic organ prolapse during gynecologic examination, Valsalva maneuver, and transperineal ultrasound. A questionnaire survey of the patients revealed satisfaction with the results of surgery and improvement of the quality of life. Conclusion. The study demonstrated the efficacy and safety of combined laparoscopic surgery for uterine leiomyoma and stage II apical prolapse in premenopausal patients with polyvalent allergy. The surgery contributed to the normalization of anatomical relations in the small pelvis and relieving the apical prolapse symptoms. The use of titanium mesh implants minimized the risk of allergic reactions and mesh-associated complications, which resulted in satisfaction with the results of surgery and improvement in the quality of life of the patients. Key words: pelvic organ prolapse, apical prolapse, hysterectomy, titanium mesh implants