Related Experiment Video
Updated: Jul 31, 2025
Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
Published on: October 25, 2024
Laparoscopic sacrocolpopexy versus vaginal sacrospinous fixation for vaginal vault prolapse: a randomised controlled
Anique M J van Oudheusden1,2, Mèlanie N van IJsselmuiden2,3, Leah F Menge4
1Department of Gynaecology and Obstetrics, VieCuri Medical Centre, Venlo, The Netherlands.
Objective:
To determine whether laparoscopic sacrocolpopexy (LSC) or vaginal sacrospinous fixation (VSF) is the most optimal surgical treatment in patients with POP-Q stage ≥2 vaginal vault prolapse (VVP).
Design:
Multicentre randomised controlled trial (RCT) and prospective cohort study alongside.
Setting:
Seven non-university teaching hospitals and two university hospitals in the Netherlands.
Population:
Patients with symptomatic post-hysterectomy vaginal vault prolapse, requiring surgical treatment.
Methods:
Randomisation in a 1:1 ratio to LSC or VSF. Evaluation of prolapse was done using the pelvic organ prolapse quantification (POP-Q). All participants were asked to fill in various Dutch validated questionnaires 12 months postoperatively.
Main Outcome Measures:
Primary outcome was disease-specific quality of life. Secondary outcomes included composite outcome of success and anatomical failure. Furthermore, we examined peri-operative data, complications and sexual function.
Results:
A total of 179 women, 64 women randomised and 115 women, participated in a prospective cohort. Disease-specific quality of life did not differ after 12 months between the LSC and VSF group in the RCT and the cohort (RCT: P = 0.887; cohort: P = 0.704). The composite outcomes of success for the apical compartment, in the RCT and cohort, were 89.3% and 90.3% in the LSC group and 86.2% and 87.8% in the VSF group, respectively (RCT: P = 0.810; cohort: P = 0.905). There were no differences in number of reinterventions and complications between both groups (reinterventions RCT: P = 0.934; cohort: P = 0.120; complications RCT: P = 0.395; cohort: P = 0.129).
Conclusions:
LSC and VSF are both effective treatments for vaginal vault prolapse, after a follow-up period of 12 months.
