Composite Failure Associated With Sacrohysteropexy and Sacrocolpopexy With Supracervical Hysterectomy for Advanced Pelvic Organ Prolapse.

Objectives: Failures and complications associated with treatments comprising laparoscopic sacrohysteropexy (SHP) for advanced pelvic organ prolapse (POP) are unclear. We compared failure rates associated with SHP and laparoscopic supracervical hysterectomy (SCH)/sacrocolpopexy (SCP) for advanced POP to determine whether they differed.

Methods: Clinical data of patients who underwent SHP (n = 52) and SCH/SCP (n = 209) were retrospectively examined. Only patients with advanced Pelvic Organ Prolapse Quantification stage III or IV were included. A single surgeon performed the procedures between October 2019 and October 2022. The primary objective was to compare the composite failure (CF) rates of both groups during the first year after surgery. CF was defined as the leading edge of any compartment beyond the hymen, the presence of subjective bulging, or the need for reoperation. The secondary objective was to analyze complications within 30 days and 1 year postoperatively.

Results: CF rates at 1 year were 13.5% and 5.7% with SHP and SCH/SCP, respectively (odds ratio [OR], 2.54; 95% confidence interval [CI], 0.80-7.48; p = 0.072). The 30-day perioperative complication rates were 3.8% and 3.3% with SHP and SCH/SCP, respectively (OR, 0.66; 95% CI, 0.069-3.1). The postoperative complication rates were 1.9% and 4.3% with SHP and SCH/SCP, respectively (OR, 0.44; 95% CI, 0.0097-3.3).

Conclusions: Complications associated with SHP for advanced POP did not differ from those associated with SCH/SCP. However, the occurrence of CF was higher with SHP, indicating a potentially clinically meaningful difference.

Clinical trial registration: This retrospective cohort study of human participants performed at Hokusuikai-Kinen Hospital was conducted in accordance with the principles embodied in the Declaration of Helsinki and approved by the Institutional Review Board (approval number 2022-080).