- Comparison of recurrence rates with different surgical approaches for pelvic organ prolapse
Comparison of recurrence rates with different surgical approaches for pelvic organ prolapse
Ukrainian Journal Health of Woman. 2025. 5(180): 15-20. doi: 10.15574/HW.2025.5(180).1520
Kaminskyy V. V.1, Bondaruk V. P.2, Bevz G. V.3, Chayka V. V.1, Vozniuk A. V.3, Bodnarchuk O. V.4
1Shupyk National Healthcare University of Ukraine, Kyiv
2Kyiv City Center for Reproductive and Perinatal Medicine, Ukraine
3National Pirogov Memorial Medical University, Vinnytsia, Ukraine
4Vinnytsia Regional Hospital named after M.I. Pirogov, Ukraine
For citation: Kaminskyy VV, Bondaruk VP, Bevz GV, Chayka VV, Vozniuk AV, Bodnarchuk OV. (2025). Comparison of recurrence rates with different surgical approaches for pelvic organ prolapse. Ukrainian Journal Health of Woman. 5(180): 15-20. doi: 10.15574/HW.2025.5(180).1520
Article received: Jun 28, 2025. Accepted for publication: Oct 30, 2025.
To date, there are insufficient data on the effectiveness of new laparoscopic approaches for the treatment of genital prolapse compared with vaginal surgery.
Aim – to determine the recurrence rate of genital prolapse after different surgical treatment options in women to compare the effectiveness of these treatment methods.
Materials and methods. The recurrence rate of genital prolapse was analyzed in 389 women, of whom 239 underwent vaginal surgery and 150 underwent laparoscopic surgical interventions. The types of interventions were as follows: for apical prolapse – vaginal hysterectomy (VH) without sacrospinous fixation and VH with sacrospinous fixation; for mixed prolapse – VH without sacrospinous fixation and VH with sacrospinous fixation; for apical prolapse – laparoscopic hysterectomy (LH) with promontofixation, with bilateral suspension, and with pectopexy; for mixed prolapse – laparoscopic LH with promontofixation and with pectopexy. Statistical analysis was performed using the SPSS 21 software.
Results. Laparoscopic surgical interventions for the correction of genital prolapse reduced the risk of recurrence from 34.7% to 18.7%, compared with vaginal surgery. Regardless of the type of genital prolapse, supplementation of vaginal hysterectomy with sacrospinous fixation was necessary, as it reduced the recurrence rate by 23.3% in apical prolapse and by 24.1% in mixed prolapse. The recurrence rate did not depend on the choice of the primary laparoscopic procedure in patients with apical prolapse; however, in cases of mixed prolapse, laparoscopic hysterectomy with promontofixation reduced the recurrence rate by 23.4%.
Conclusions. The obtained data indicate a higher effectiveness of various laparoscopic surgical approaches for the treatment of genital prolapse in women, as evidenced by a 1.9-time reduction in the risk of disease recurrence.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patients was obtained for conducting the studies.
The authors declare no conflict of interest.
Keywords: genital prolapse, vaginal surgery, laparoscopy, pelvic surgery, recurrence.
REFERENCES
1. Andebrhan SB, Caron AT, Szlachta-McGinn A, Parameshwar PS, Jackson NJ, Rosenman AE et al. (2023). Pelvic organ prolapse recurrence after pregnancy following uterine-sparing prolapse repair: a systematic review and meta-analysis. Int Urogynecol J. 34(2): 345-356. https://doi.org/10.1007/s00192-022-05306-2; PMid:35920935
2. Azadi A, Ulibarri H, Arroyo A, Gonzalez Herrera D, Hamilton B et al. (2025). Meta-Analysis of Laparoscopic Versus Vaginal Uterosacral Ligament Suspension. J Minim Invasive Gynecol. 32(10): 877-888. https://doi.org/10.1016/j.jmig.2025.07.001; PMid:40617284
3. Barcz EM. (2023). Pelvic organ prolapse surgery. What techniques should be used? Ginekol Pol. 94(10): 771-772. https://doi.org/10.5603/gpl.97743; PMid:37934878
4. Boyles SH, Weber AM, Meyn L. (2003). Procedures for pelvic organ prolapse in the United States, 1979-1997. Am J Obstet Gynecol. 188(1): 108-15. https://doi.org/10.1067/mob.2003.101; PMid:12548203
5. Carroll L, Sullivan CO, Doody C, Perrotta C, Fullen BM. (2023). Pelvic organ prolapse: Women's experiences of Accessing Care & Recommendations for improvement. BMC Womens Health. 23(1): 672. https://doi.org/10.1186/s12905-023-02832-z; PMid:38114966 PMCid:PMC10729347
6. Chan CYW, Fernandes RA, Yao HH, O'Connell HE, Tse V, Gani J. (2023). A systematic review of the surgical management of apical pelvic organ prolapse. Int Urogynecol J. 34(4): 825-841. https://doi.org/10.1007/s00192-022-05408-x; PMid:36462058
7. Collins S, Lewicky-Gaupp C. (2022). Pelvic Organ Prolapse. Gastroenterol Clin North Am. 51(1): 177-193. https://doi.org/10.1016/j.gtc.2021.10.011; PMid:35135661
8. Dietz HP, Chavez-Coloma L, Friedman T, Turel F. (2022). Pelvic organ prolapse in nulliparae. Aust N Z J Obstet Gynaecol. 62(3): 420-425. https://doi.org/10.1111/ajo.13481; PMid:35048356 PMCid:PMC9305753
9. Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. (2002). Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 186(6): 1160-6. https://doi.org/10.1067/mob.2002.123819; PMid:12066091 PMCid:PMC8782331
10. Jones KA, Shepherd JP, Oliphant SS, Wang L, Bunker CH, Lowder JL. (2010). Trends in inpatient prolapse procedures in the United States, 1979-2006. Am J Obstet Gynecol. 202(5): 501.e1-7. https://doi.org/10.1016/j.ajog.2010.01.017; PMid:20223444 PMCid:PMC3097054
11. Kuittinen T, Tulokas S, Rahkola-Soisalo P, Brummer T, Jalkanen J, Tomas E et al. (2023). Pelvic organ prolapse after hysterectomy: A 10-year national follow-up study. Acta Obstet Gynecol Scand. 102(5) :556-566. https://doi.org/10.1111/aogs.14542; PMid:37014706 PMCid:PMC10072247
12. Li YT, Chang CP, Wang PH. (2023). Pelvic organ prolapse: Minimally invasive approach. J Chin Med Assoc. 86(8): 715-716. https://doi.org/10.1097/JCMA.0000000000000948; PMid:37308454 PMCid:PMC12755519
13. McLeod LJ, Lee PE. (2023). Pelvic organ prolapse. CMAJ. 195(30): E1013. https://doi.org/10.1503/cmaj.230089; PMid:37553149 PMCid:PMC10446149
14. Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J et al. (2008). Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 300(11): 1311-6. https://doi.org/10.1001/jama.300.11.1311; PMid:18799443 PMCid:PMC2918416
15. Pizzoferrato AC, Thuillier C, Vénara A, Bornsztein N, Bouquet S, Cayrac M et al. (2023). Management of female pelvic organ prolapse-Summary of the 2021 HAS guidelines. J Gynecol Obstet Hum Reprod. 52(3): 102535. doi: 10.1016/j.jogoh.2023.102535.https://doi.org/10.1016/j.jogoh.2023.102535; PMid:36657614
16. Rappa C, Saccone G. (2016). Recurrence of vaginal prolapse after total vaginal hysterectomy with concurrent vaginal uterosacral ligament suspension: comparison between normal-weight and overweight women. Am J Obstet Gynecol. 215(5): 601.e1-601.e4. https://doi.org/10.1016/j.ajog.2016.06.022; PMid:27342042
17. Roos EJ, Schuit E. (2021). Timing of recurrence after surgery in pelvic organ prolapse. Int Urogynecol J. 32(8): 2169-2176. https://doi.org/10.1007/s00192-021-04754-6; PMid:33730233
18. Rortveit G, Brown JS, Thom DH, Van Den Eeden SK, Creasman JM, Subak LL. (2007). Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol. 109(6): 1396-403. https://doi.org/10.1097/01.AOG.0000263469.68106.90; PMid:17540813
19. Swift S, Woodman P, O'Boyle A, Kahn M, Valley M, Bland D et al. (2005). Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 192(3): 795-806. https://doi.org/10.1016/j.ajog.2004.10.602; PMid:15746674
20. Swift SE. (2000). The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol. 183(2): 277-85. https://doi.org/10.1067/mob.2000.107583; PMid:10942459
21. Tegerstedt G, Maehle-Schmidt M, Nyrén O, Hammarström M. (2005). Prevalence of symptomatic pelvic organ prolapse in a Swedish population. Int Urogynecol J Pelvic Floor Dysfunct. 16(6): 497-503. https://doi.org/10.1007/s00192-005-1326-1; PMid:15986100
22. Tunn R, Baessler K, Knüpfer S, Hampel C. (2023). Urinary Incontinence and Pelvic Organ Prolapse in Women. Dtsch Arztebl Int. 120(5): 71-80. https://doi.org/10.3238/arztebl.m2022.0406
23. Wu JM, Matthews CA, Conover MM, Pate V, Funk MJ. (2014). Lifetime risk of surgery for pelvic organ prolapse or urinary incontinence. Int Urogynecol J. 25(11): 1559-1566.
24. Zhuk SI, Budchenko EA. (2018). Prophylaxis of genital prolapse in women in the late postpartum period. Health of woman. 3 (129): 31-33. https://doi.org/10.15574/HW.2018.129.31
