Laparoscopy and abdominal approach are both good for prolapse correction.However, there are no data in the literature beyond 10 years. This study was an update of our previous randomized trial that compared the anatomical and functional outcomes of open and laparoscopic colposacropexy

This was an update of a noninferiority prospective randomized trial conducted in a tertiary Urology unit, comparing open and laparoscopic sacrocolpopexy in patients with symptomatic prolapse stage III and IV, according to the Pelvic Organ Prolapse quantification. Patients included in the previous study were evaluated at 1,3,6,12 months and then annually after surgery. The follow-up visit was always conducted by the same urologist, who was different from the surgeon.  All data were collected in a database during follow-up. Anatomical and functional, and subjective outcomes at the last follow-up visit were compared. Cure was defined as prolapse stage 1 or less, point C/D -5 or less at the apex and at least 7 cm total vaginal length. The Mann-Whitney and Wilcoxon tests for unpaired and paired data, respectively, were used to compare ordinal and nonnormally distributed continuous variables. Categorical data were analysed by the McNemar, chi-square or Fisher exact test. Two-tailed P <.05 was considered significant.

A total of 121 patients were eligible for study. 12 and 14 patients were lost during follow-up in the open and laparoscopic group respectively. We compared 48 and 47 patients treated with open and laparoscopic sacrocolpopexy, respectively. The mean follow up was of 177.6 months .At a mean follow up of 41.7 months the cure rate was of 100% for both approaches. At last visit the cure rate was 82% and 89% in laparoscopic and open approaches respectively. The persistence of prolapse in both groups were II stage and all asymptomatic. One and two patients in the open and laparoscopic groups respectively had de novo prolapse, occurrence after the first study, however they are always asymptomatic and untreated. Table 1 showed that at the last visit there were no differences between the two approaches for both functional and anatomical outcomes, with a good patients’ satisfaction

Anatomic and functional success rate was high in both groups.Both techniques are valid even after 14 years, probably because they both allow good correction regardless of the perioperative and postoperative advantages of laparoscopy.

After 14 years of follow-up, the anatomical and functional outcomes are  excellent with both approaches, which can then be used according to the clinical case

Continence 15S (2025) 101973
DOI: 10.1016/j.cont.2025.101973