Comparison of laparoscopic hysteropectopexy and vaginal hysterectomy in women with pelvic organ prolapse.

Background: To study whether laparoscopic hysteropectopexy (LHP) can be substituted for vaginal hysterectomy (VH) in patients with pelvic organ prolapse (POP), we compared VH with the relatively new procedure, LHP.

Methods: This retrospective study included 176 women who underwent LHP (N.=54) or VH (N.=122) for a Pelvic Organ Prolapse Quantification (POP-Q) System stage 2 or higher pelvic organ prolapse between January 2011 and December 2019. We compared the surgical outcomes and overall rate of complications between the two groups.

Results: The average length of hospitalization was 5.28 days for the LHP group and 7.08 days for the VH group. EBL (mL) in the LHP group was 32.2, whereas it was 47.7 in the VH group. The average operation time (min) was 68.2 in the LHP group and 98.9 in the VH group. Twenty-seven patients (22.1%) in the VH group had postoperative voiding difficulty compared with 2 patients (3.7%) in the LHP group. The overall number of intraoperative complications was 6 (11%) in the LHP group and 34 (27.9%) in the VH group.

Conclusions: This study demonstrated that LHP is more effective than VH in patients with POP. However, since the number of cases was small and retrospective studies are limited, we recommend a randomized controlled trial to be conducted in the future to confirm our results.