Objective: To assess the incidence of serious complications and
reoperations for recurrence after pelvic organ prolapse (POP) surgery
and compare the three most common types of repair. Design: Prospective
cohort study using a registry. Setting: 19 surgical centres in France.
Population: 2309 women participated between 2017 and 2019. Methods: a
multivariate analysis including an inverse probability of treatment
weighting approach was used to obtain three comparable groups. Main
outcome measures: Serious complications and subsequent reoperations for
POP recurrence Results: Mean follow-up was 16.6 months. Surgeries
included in the analysis were native tissue vaginal repair (N=504),
transvaginal mesh placement (692), and laparoscopic sacropexy with mesh
(1113). Serious complications occurred among 52 women (2.3%), and
reoperation for recurrence was required for 32 (1.4%). At one year, the
cumulative weighted incidence of serious complications was 1.8% for
native tissue vaginal repair (95% confidence interval 0-3.9), 3.9% for
transvaginal mesh (2.0-5.9), and 2.2% for sacropexy (1.1-2.6). Compared
with the native tissue vaginal repair group, the risk of serious
complications was higher in the transvaginal mesh group (weighted-HR
3.84, 2.43-6.08), and the sacropexy group (2.48, 1.45-4.23), while the
risk of reoperation for prolapse recurrence was reduced in both groups
(transvaginal mesh [0.22, 0.13-0.39] and sacropexy [0.29,
0.18-0.47]). Conclusions: Laparoscopic sacropexy with mesh appears to
have a better risk profile (few serious complications and few
reoperations for recurrence) than transvaginal mesh placement (more
serious complications) and native tissue vaginal repair (more
reoperations for recurrence). These results are useful for informing
women and for shared decision making.
Laparoscopic Sacropexy: A Retrospective Analysis of Perioperative Complications and Anatomical Outcomes
