Background: Pelvic organ prolapse (POP) is a public health problem that influences millions of women around the globe, and it has a significant impact on the quality of life. From the FDA statement regarding the complications of using mesh implants in POP surgery to studies that have shown the benefits and side effects, we conducted a systematic review investigating the complications associated with surgical mesh implantation for POP repair. Methods: Relevant studies were identified through a comprehensive search of scientific databases. Studies evaluating the use of mesh in POP surgery and reporting on associated complications were included. Results: Among 2816 studies, 28 studies met the research criteria, with a total number of 8958 patients, revealing that in laparoscopic mesh surgery, the rate of mesh exposure was lower compared to vaginal mesh surgery, among other complications. Conclusions: Laparoscopic mesh surgery is superior as a long-term approach for POP repair compared to vaginal mesh surgery, offering lower complication rates and potentially better anatomical success. However, vaginal mesh surgery remains a valuable option for patients who are unsuitable for laparoscopy due to specific factors. Future research should explore alternative techniques, like pectopexy with or without mesh, to further improve surgical outcomes and patient experience.

Although ovarian cystic teratoma is the most common ovarian tumor, complications are quite rare. However, it is important to be recognized by the radiologist in order to avoid inaccurately diagnosing them as malignant lesions. This case report describes a 61-year-old postmenopausal woman, who presented to the emergency room with abdominal pain following a minor blunt abdominal trauma. In this context, a CT scan was performed, which showed the presence of round, hypodense masses randomly distributed in the peritoneum, with coexisting ascites in moderate amount; ovarian carcinoma with peritoneal carcinomatosis was suspected. The patient was hospitalized and an MRI of the abdomen and pelvis was recommended for a more detailed lesion characterization. Following this examination, the patient was diagnosed with mature cystic ovarian teratoma complicated by rupture. Surgery was performed, and the outcome was favorable. The cases of ruptured cystic teratomas are rare, and to our knowledge, this is the first occurrence described in literature. Special attention must be paid when confronting with such a case in medical practice, since it can easily misdiagnosed as peritoneal carcinomatosis.

A cesarean scar ectopic pregnancy (CSP) represents an uncommon yet potentially life-threatening condition requiring immediate and efficient management. We present a case of a 32-year-old woman diagnosed with a scar pregnancy at 8 weeks of gestation. Laparoscopic surgical management was chosen due to its minimally invasive nature and potential for preserving fertility. During the procedure, temporary clipping of uterine arteries was employed to control intraoperative bleeding. The patient recovered well postoperatively with no complications. This case highlights the feasibility and effectiveness of laparoscopic intervention combined with temporary uterine artery clipping in the management of scar pregnancies, offering a valuable approach for clinicians faced with similar cases. Through this report, we aim to contribute to the existing literature on the optimal management of CSP and highlight the efficacy of laparoscopic surgery in this context.

Although ovarian cystic teratoma is the most common ovarian tumor, complications are quite rare. However, it is important to be recognized by the radiologist in order to avoid inaccurately diagnosing them as malignant lesions. This case report describes a 61-year-old postmenopausal woman, who presented to the emergency room with abdominal pain following a minor blunt abdominal trauma. In this context, a CT scan was performed, which showed the presence of round, hypodense masses randomly distributed in the peritoneum, with coexisting ascites in moderate amount; ovarian carcinoma with peritoneal carcinomatosis was suspected. The patient was hospitalized and an MRI of the abdomen and pelvis was recommended for a more detailed lesion characterization. Following this examination, the patient was diagnosed with mature cystic ovarian teratoma complicated by rupture. Surgery was performed, and the outcome was favorable. The cases of ruptured cystic teratomas are rare, and to our knowledge, this is the first occurrence described in literature. Special attention must be paid when confronting with such a case in medical practice, since it can easily misdiagnosed as peritoneal carcinomatosis

Background: Restoration of apical support is a primary objective in pelvic organ prolapse surgery; however, postoperative pelvic floor biomechanics and vaginal axis orientation are increasingly recognized as relevant determinants of clinical outcome. Laparoscopic pectopexy may be performed using synthetic mesh or non-absorbable sutures (wire), yet the influence of fixation material on postoperative vaginal axis remains insufficiently explored. This study aimed to evaluate vaginal axis orientation after mesh versus wire pectopexy using magnetic resonance imaging (MRI). Methods: A prospective non-randomized comparative cohort study included 100 women with symptomatic apical pelvic organ prolapse (POP-Q stage ≥ II). Fifty patients underwent mesh pectopexy and fifty wire pectopexy. All patients underwent standardized postoperative pelvic MRI at one-year follow-up using a 1.5 Tesla scanner with dynamic Valsalva sequences. MRI measurements included vaginal PS3L axis angle, H-line, and M-line. Clinical outcomes were assessed by gynecological examination. Statistical analysis included ANOVA, logistic regression, and ROC curve evaluation. Results: No cases of apical prolapse recurrence were observed. Vaginal axis orientation was significantly associated with postoperative clinical findings (F = 3.867, p = 0.019). Logistic regression identified vaginal axis angle as an independent predictor of normal clinical outcome (β = −0.257, p = 0.008; AUC = 0.819). A more physiological vaginal axis was more frequently observed following wire pectopexy Conclusions: Postoperative vaginal axis orientation assessed by MRI represents a relevant parameter after apical prolapse repair. Wire pectopexy was associated with a more physiological vaginal axis alignment, suggesting potential biomechanical advantages that may influence postoperative pelvic floor stability.