The Outcome of Sacrocolpopexy/Sacrohysteropexy for Patients with Pelvic Organ Prolapse and Predictors of Anatomical Failure
Open accessAbstract
Background: Pelvic organ prolapse (POP) is a medical condition that profoundly impacts women's quality of life. Unfortunately, the literature lacks long-term predictors and risk factors for its recurrence. This study aims to assess the efficacy and safety of Sacrocolpopexy/Sacrohysteropexy and to identify the predictors of recurrence in a Saudi setting. Methods: In a retrospective cohort study, all patients who underwent Sacrocolpopexy (n=144) and Sacrohysteropexy (n=56) between 2009-2021 were followed up. Electronic medical records were examined to collect data on the following: Patient characteristics [age, parity, BMI, and past medical and surgical history], prolapse-related characteristics/symptoms, Surgery-related characteristics [type and approach of surgery, mesh type, and concomitant surgery], and Outcome characteristics. Postoperative anatomical success and failure rates were determined according to the Baden-Walker classification. Logistic regression analysis was applied to identify the predictors of overall anatomical failure of Sacrocolpopexy. Significance was considered at p<0.05. Results: Success rates of 96.8%, 99.4%, and 85.2% were detected in the anterior, apical, and posterior vaginal prolapse, respectively, with an overall success rate of 83.1%. The overall failure rate was 15.9%, with an incidence density of 5.98 per 100 women-years. The onset of failure in 27 failure cases ranged from 40 days to 11.5 years postoperative. After adjustment for the possible potential confounders, older age (OR=1.06, 95% CI:1.01‒1.13, p=0.03) and the presence of diabetes (OR=4.93, 95% CI:1.33‒18.33, p=0.02) were the only significant predictors of operation failure. As for complications, six cases (3.6%) required reoperation, two cases (1.2%) had a bowel obstruction two and seven years after surgery, and one patient (0.6%) had vaginal mesh exposure. Conclusion: The outcomes of Sacrocolpopexy/Sacrohysteropexy in our study are comparable to those in previous studies. Diabetes and elder age at the time of the surgery played a role in predicting recurrence. Sacrocolpopexy has a long-term profile of safety and efficacy. These findings could be key to stratifying surgical plans for pelvic organ prolapse cases.
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These findings contrast with previous observational studies that reported higher mesh exposure rates when total hysterectomy or vaginal mesh procedures were included.
“These findings contrast with previous observational studies that reported higher mesh exposure rates when total hysterectomy or vaginal mesh procedures were included [15–24, 29].”
From Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse (2026) · cites this paper as [20]
The Results (Complications; page unavailable) report vaginal mesh exposure in 1 of 170 patients (0.6%), and the Discussion (Complications; page unavailable) cites another study’s 2.1% exposure rate. The Methods mention total hysterectomy and vaginal mesh procedures, but the paper does not report higher exposure rates specifically when either was included. (LLM, conf=0.77)
Experimental — accuracy not yet measuredA previous publication reported comparable subjective and objective efficacy between laparoscopic sacrocolpopexy with subtotal hysterectomy and laparoscopic sacrohysteropexy.
“A previous publication reported comparable subjective and objective efficacy between these two groups [20].”
From Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse (2026) · cites this paper as [20]
The Results table (page unavailable) reports anatomical failure of 8.7% after sacrohysteropexy versus 18.5% after sacrocolpopexy, a difference that was not statistically significant (p=0.12). The paper reports subjective symptom improvement, but not a comparison of subjective efficacy between the two groups. The Methods also include some open or robotic procedures and do not restrict the sacrocolpopexy group to subtotal hysterectomy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAll cases were performed using the same surgical technique, sutures, and mesh materials as previously described by the research team.
“All cases were performed using the same surgical technique, sutures, and mesh materials as previously described by our research team [20].”
From Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse (2026) · cites this paper as [20]
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References 33 · Cited by 13
- Authors
- Alsahabi, J. A., Alsary, S., & Abolfotouh, M. A.
- Affiliations
- King Saud bin Abdulaziz University for Health Sciences (SA)
- Corresponding author
- Abolfotouh, Mostafa A
- Venue
- International Journal of Women's Health
- Publisher
- Informa UK Limited
- Published
- 2023-07
- Volume
- Volume 15
- Pages
- 1093-1105
- ISSN
- 1179-1411 (ISSN-L)
- PMC
- PMC10362893
- OpenAlex
- W4384699538
- Cited by
- 13
- References
- 33
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 2
- FWCI
- 2.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Women s Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- King Abdullah International Medical Research Center
- King Saud bin Abdulaziz University for Health Science
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Keywords
- sacrohysteropexy, pelvic organ prolapse, predictors of recurrence, diabetes mellitus, old age, mesh complications, intestinal obstruction, vaginal mesh exposure, reoperation, cystocele, apical vaginal prolapse, long-term outcomes, Saudi women, minimally invasive surgery
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