Laparoscopic sacrocolpopexy with concurrent hysterectomy or uterine preservation: A metanalysis and systematic review
Abstract
Background: Literature is lacking strong evidence about comparisons of efficacy and quality of life‐related outcomes between laparoscopic total and/or supracervical hysterectomy (LTH/LSCH) with laparoscopic sacrocolpopexy (LSC) and minimally invasive sacrohysteropexy (LSH). Objective: To summarize and compare available data on this topic providing a useful clinical tool in the treatment decision process. Search Strategy: We performed a systematic research of PubMed (MEDLINE), Web of Science, and Gooogle Scholar. Selection Criteria: We included studies that compared at least one efficacy outcome (objective or subjective outcome) between LTH/LSCH with LSC and LSH. Data on surgery‐related morbidities were also extracted where available. Data Collection and Analysis: A random‐effect meta‐analysis was conducted reporting pooled mean differences and odds ratios (OR) between groups using Review Manager V.7.9.0. Main Results: We included a total of nine observational studies. LTH/LSCH with LSH was associated with a significantly higher objective success (apical compartment OR 7.95; 95% confidence interval [CI] 2.23–28.33; I 2 = 0%; P = 0.001; anterior compartment OR 2.23; 95% CI 1.26–4.30; I 2 = 12%; P = 0.007) and subjective success (OR 3.19; 95% CI 1.42–7.17; I 2 = 39%; P = 0.005). No differences were found regarding intraoperative and postoperative complications, sexual dysfunction, and stress urinary incontinence rate after surgery. Hysteropexy showed shorter operative time and shorter hospital length with a pool mean difference of 27.37 min (95% CI 18.04–32.71; I 2 = 0%; P < 0.001) and 0.7 days (95% CI 0.24–1.17; I 2 = 75%; P = 0.003), respectively. Concurrent hysterectomy was not associated with a higher rate of mesh‐related complications ( P = 0.53). No major differences were found regarding recurrence and reoperation rate ( P = 0.10 and P = 0.93, respectively). Conclusions: LTH/LSCH with LSC has better objective and subjective outcomes in pelvic organ prolapse surgery than LSH alone, especially for apical and anterior compartments, and is not associated with higher postoperative sexual dysfunction and mesh‐related complications. Adequate preoperative counseling is highly recommended in patients who desire uterine preservation. PROSPERO Registration Number: CRD42024537270.
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A recent meta-analysis including 9 observational studies reported that laparoscopic sacrocolpopexy with hysterectomy was associated with higher subjective and objective success rates.
“A recent meta-analysis, which included 9 observational studies, compared the efficacy outcomes of total or subtotal hysterectomy with those of uterine preservation during LSC, and reported that LSC with hysterectomy was associated with higher subjective and objective success rates [12].”
From Mesh Exposure After Laparoscopic Sacrocolpopexy with Concomitant Total Hysterectomy or Uterine Preservation: A Retrospective Cohort Study (2026) · cites this paper as [12]
This result aligns with the established advantage of subtotal hysterectomy in reducing mesh contact with vaginal bacteria and preserving blood supply to the vaginal cuff tissue.
“This result aligns with the established advantage of subtotal hysterectomy in reducing mesh contact with vaginal bacteria and preserving blood supply to the vaginal cuff tissue [25].”
From Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse (2026) · cites this paper as [25]
These findings are consistent with a recent meta-analysis that demonstrated no statistically significant difference between groups in mesh extrusion or exposure.
“These findings are consistent with a recent meta-analysis that demonstrated no statistically significant difference between groups in mesh extrusion or exposure [25].”
From Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse (2026) · cites this paper as [25]
A recent meta-analysis suggested that sacrocolpopexy with hysterectomy may yield better outcomes than uterine preservation, possibly because suboptimal mesh placement is associated with laparoscopic supracervical hysterectomy.
“In contrast, a recent meta-analysis suggested that sacrocolpopexy with hysterectomy may yield better outcomes than uterine preservation, possibly because suboptimal mesh placement is associated with laparoscopic supracervical hysterectomy [25].”
From Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse (2026) · cites this paper as [25]
A recognized clinical advantage of uterine-sparing procedures is the reduced risk of mesh erosion.
“A recognized clinical advantage of uterine-sparing procedures is the reduced risk of mesh erosion [12, 17, 25].”
From Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse (2026) · cites this paper as [25]
These findings are consistent with those of Sato et al. and align with meta-analytic data suggesting that increased blood loss associated with hysterectomy-based repair is primarily attributable to total rather than subtotal hysterectomy.
“These findings are consistent with those of Sato et al. [19] and align with meta-analytic data suggesting that increased blood loss associated with hysterectomy-based repair is primarily attributable to total rather than subtotal hysterectomy [17, 19, 25].”
From Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse (2026) · cites this paper as [25]
A recent meta-analysis found that concurrent hysterectomy during laparoscopic sacrocolpopexy was not associated with a higher rate of mesh-related complications but was associated with higher objective and subjective success rates.
“A recent meta-analysis compared laparoscopic total or supracervical hysterectomy with uterine preservation during LSC, and the results showed that concurrent hysterectomy was not associated with a higher rate of mesh-related complications but was associated with higher objective and subjective success rates [12].”
From Mesh Exposure After Laparoscopic Sacrocolpopexy with Concomitant Total Hysterectomy or Uterine Preservation: A Retrospective Cohort Study (2026) · cites this paper as [12]
Whether concurrent hysterectomy increases the risk of mesh exposure remains a controversial issue.
“Whether concurrent hysterectomy increases the risk of mesh exposure remains a controversial issue.”
From Mesh Exposure After Laparoscopic Sacrocolpopexy with Concomitant Total Hysterectomy or Uterine Preservation: A Retrospective Cohort Study (2026) · cites this paper as [12]
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Sartori, M. G. F., Brito, L. G. O., Schreiner, L., do Rêgo, A. D., Picoloto, A. S. B., Bilhar, A. P. M., Delroy, C. A., Prado, D. S., de Oliveira, E., Haddad, J. M., et al. (2026) · Femina · doi:10.61622/0100-7254546202602
- Authors
- Tius, V., Arcieri, M., Taliento, C., Pellecchia, G., Capobianco, G., Simoncini, T., Panico, G., Caramazza, D., Campagna, G., Driul, L., Scambia, G., Ercoli, A., Restaino, S., & Vizzielli, G.
- Affiliations
- University of Udine (IT)
- Ospedale Santa Maria della Misericordia di Udine (IT)
- University of Ferrara (IT)
- University of Sassari (IT)
- University of Pisa (IT)
- Agostino Gemelli University Polyclinic (IT)
- University of Messina (IT)
- Corresponding author
- Arcieri, Martina
- ORCID
- Venue
- International Journal of Gynecology & Obstetrics
- Publisher
- Wiley
- Published
- 2024-09-26
- Volume
- 168
- Issue
- 2
- Pages
- 456-471
- ISSN
- 0020-6695 (ISSN-L)
- 0020-7292
- 1879-3479
- OpenAlex
- W4402872494
- Cited by
- 16
- References
- 51
- Citations by year
- 2026: 6 · 2025: 10
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- International Journal of Gynecology & Obstetrics (publishedVersion)
- PubMed (publishedVersion)
- UnissResearch (Università degli Studi di Sassari) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- laparoscopic sacrocolpopexy, subtotal hysterectomy, total laparoscopic hysterectomy, uterine preservation, sacrohysteropexy, pelvic organ prolapse, surgical success, mesh complications, operative time, length of hospital stay, sexual dysfunction, stress urinary incontinence, quality of life, minimally invasive surgery
- MeSH terms
- Female, Humans, Hysterectomy, Laparoscopy, Postoperative Complications, Quality of Life, Uterus, Treatment Outcome, Pelvic Organ Prolapse, Organ Sparing Treatments
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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