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Updated: Mar 27, 2026
Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
Published on: October 25, 2024
Laparoscopic Versus Abdominal Sacrocolpopexy: A Randomized, Controlled Trial
Elisabetta Costantini1, Luigi Mearini1, Massimo Lazzeri1
1Urology and Andrology Clinic, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy; Department of Urology, Humanitas Clinical and Research Center, Humanitas University (ML), Rozzano, Italy.
Laparoscopic sacrocolpopexy offers comparable anatomical correction for pelvic organ prolapse repair as the abdominal approach. However, the laparoscopic method shows higher recurrence rates, particularly for anterior compartment prolapse.
Area of Science:
- Urology
- Gynecology
- Minimally Invasive Surgery
Background:
- Pelvic organ prolapse (POP) significantly impacts women's quality of life.
- Surgical repair options include abdominal and laparoscopic sacrocolpopexy.
- Limited randomized trials compare these two approaches.
Purpose of the Study:
- To test the hypothesis that laparoscopic sacrocolpopexy is non-inferior to abdominal sacrocolpopexy for POP repair.
- To compare anatomical cure rates, recurrence, and patient-reported outcomes.
Main Methods:
- A randomized controlled trial involving 200 women with symptomatic POP (stage 2 or greater).
- Comparison of abdominal sacrocolpopexy (60 patients) versus laparoscopic sacrocolpopexy (61 patients).
- Primary outcome: Pelvic Organ Prolapse Quantification (POP-Q) system; cure defined as stage 1 or less.
Main Results:
- 100% anatomical cure rate at a mean follow-up of 41.7 months for both groups.
- Significantly earlier recurrence observed in the laparoscopic group (p=0.030), especially within the first year.
- Higher rates of anterior compartment descensus in the laparoscopic group (11 vs 1, p=0.004).
Conclusions:
- Laparoscopic sacrocolpopexy achieves similar anatomical correction to abdominal sacrocolpopexy.
- The abdominal approach demonstrates superior long-term recurrence-free survival, particularly for anterior POP.
- Laparoscopic sacrocolpopexy may not be equivalent for all POP compartments.
