Comparison between laparoscopic sacrocolpopexy with hysterectomy and hysteropexy in advanced urogenital prolapse

Introduction and hypothesis The aim of this study was to compare the outcomes in women who underwent laparoscopic sacrocolpopexy (LSC) with or without hysterectomy for pelvic organ prolapse (POP). Methods This was a single-centre prospective study. We included women with symptomatic POP (III–IV stage) who underwent LSC with or without hysterectomy. The preoperative evaluation included a history, clinical examination and urodynamic test; all patients completed FSFI, UDI-6 and IIQ-7 questionnaires. They were followed up at 1, 3, 6 and 12 months after surgery and then annually thereafter with the same preoperative flow chart. At the last visit, they also completed the PGI-I questionnaire. Results Between 2012 and 2016, a total of 136 patients with POP were included (82 in the LSC with hysterectomy group and 54 in the hysteropexy group). At a median follow-up of 65.3 months (36–84 months), there were improvements in the anatomical and functional outcomes of both groups without differences between the two approaches. The apical success rate was 100% in all women, without recurrence in either group; the anterior and posterior success rates of hysterectomy were higher than those of uterine preservation. Conclusion This study showed that there were no differences in the anatomical and functional outcomes between LSC with or without hysterectomy for POP.