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Review
. 2025 Oct 3.
doi: 10.1007/s00404-025-08210-4. Online ahead of print.

Lateral suspension vs. sacral colpopexy for treating pelvic organ prolapse: a systematic review and meta-analysis

Andrea Lombisani #  1 , Veronica Tius #  2 , Chiara Ferraro  3 , Martina Arcieri  4 , Lorenzo Vacca  1 , Daniela Caramazza  1 , Stefano Restaino  4   5 , Tommaso Simoncini  6 , Giampiero Capobianco  7 , Alfredo Ercoli  8 , Giovanni Scambia  3   9 , Giuseppe Vizzielli #  10   11 , Giuseppe Campagna #  1
Affiliations
Review

Lateral suspension vs. sacral colpopexy for treating pelvic organ prolapse: a systematic review and meta-analysis

Andrea Lombisani et al. Arch Gynecol Obstet. .

Abstract

Purpose: Although sacral colpopexy is considered the gold standard for correcting apical prolapse, it is associated with extended operative times and surgical complications. An alternative surgical approach is currently being investigated. This meta-analysis aims to summarize and compare the available data on laparoscopic sacral colpopexy (LSCP) and laparoscopic lateral suspension (LLS) as per the Dubuisson technique.

Methods: A systematic search of PubMed (MEDLINE) and Google Scholar was conducted from the inception of each database until December 2024. Studies comparing LSCP and LLS on at least one efficacy outcome selected. Objective or subjective success rate, surgery-related data and follow-up data were extracted. Results were pooled using a random-effect meta-analysis.

Results: A total of 6 studies were included. The meta-analysis did not report statistical differences between LSCP and LLS in terms of apical prolapse [OR = 1.24; CI 95% (0.61, 2.52); I2 = 0%; P = 0.55] and anterior prolapse [OR = 0.78; CI 95% (0.45, 1.37); I2 = 0%; P = 0.39] correction. Subjective success rate was similar (P = 0.72). LLS required shorter operative time [43.1 min, CI 95% (16.75, 69.45); I2 = 97%; P = 0.001]. No major differences were found regarding intraoperative and early post-operative complications, re-operation and recurrence rates. Follow-up data regarding quality of life showed no significant differences about de novo stress urinary incontinence, intestinal impairment, sexual function, and pain after surgery.

Conclusions: LLS provides similar outcomes to LSCP for apical and anterior prolapse in selected cases. However, limited long-term data and few studies on advanced prolapse prevent LLS from being declared an equally effective alternative at this time.

Prospero registration number: CRD42024537270.

Keywords: Laparoscopy; Lateral suspension; Mesh; Minimally invasive surgery; Pelvic organ prolapse; Sacral colpopexy; Sacral suspension.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

References

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