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Randomized Controlled Trial
. 2023 Jan;34(1):93-104.
doi: 10.1007/s00192-022-05350-y. Epub 2022 Sep 16.

Laparoscopic sacrocolpopexy versus abdominal sacrocolpopexy for vaginal vault prolapse: long-term follow-up of a randomized controlled trial

Anique M J van Oudheusden  1   2 , Josephine Eissing  3 , Ivon M Terink  4 , Maarten D H Vink  5 , Sander M J van Kuijk  6 , Marlies Y Bongers  7   8 , Anne-Lotte W M Coolen  9
Affiliations
Randomized Controlled Trial

Laparoscopic sacrocolpopexy versus abdominal sacrocolpopexy for vaginal vault prolapse: long-term follow-up of a randomized controlled trial

Anique M J van Oudheusden et al. Int Urogynecol J. 2023 Jan.

Abstract

Introduction and hypothesis: The objective of this study was to evaluate long-term outcomes of laparoscopic sacrocolpopexy (LSC) versus abdominal sacrocolpopexy (ASC) for vaginal vault prolapse (VVP).

Methods: Long-term follow-up of a multicenter randomized controlled trial (SALTO trial). A total of 74 women were randomly assigned to LSC (n=37) or ASC (n=37). Primary outcome was disease-specific quality of life, measured with validated questionnaires. Secondary outcomes included anatomical outcome, composite outcome of success, complications, and retreatment.

Results: We analyzed 22 patients in the LSC group and 19 patients in the ASC group for long-term follow-up, with a median follow-up of 109 months (9.1 years). Disease-specific quality of life did not differ after long-term follow-up with median scores of 0.0 (LSC: IQR 0-17; ASC: IQR 0-0) on the "genital prolapse" domain of the Urogenital Distress Inventory in both groups (p = 0.175). Anatomical outcomes were the same for both groups on all points of the POP-Q. The composite outcome of success for the apical compartment is 78.6% (n = 11) in the LSC group and 84.6% (n = 11) in the ASC group (p = 0.686). Mesh exposures occurred in 2 patients (12.5%) in the LSC group and 1 patient (7.7%) in the ASC group. There were 5 surgical reinterventions in both groups (LSC: 22.7%; ASC: 26.3%, p = 0.729).

Conclusions: At long-term follow-up no substantial differences in quality of life, anatomical results, complications, or reinterventions between LSC and ASC were observed. Therefore, the laparoscopic approach is preferable, considering the short-term advantages.

Trial registration: Dutch Trial Register NTR6330, 18 January 2017, https://www.trialregister.nl/trial/5964.

Keywords: Abdominal sacrocolpopexy; Laparoscopic sacrocolpopexy; Mesh exposure; Post-hysterectomy prolapse; Vaginal vault prolapse.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Flow diagram of study population. FU follow-up, POP-Q Pelvic Organ Prolapse Quantification
Fig. 2
Fig. 2
Survival analysis for time to surgical retreatment. Time (months) to surgical retreatment, p = 0.814. ASC abdominal sacrocolpopexy, LSP laparoscopic sacrocolpopexy
See this image and copyright information in PMC

References

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