{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:35:00Z","timestamp":1791513300637,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004690","name":"Minist\u00e8re de la Sant\u00e9","doi-asserted-by":"publisher","award":["PHRC 2012\/0276"],"award-info":[{"award-number":["PHRC 2012\/0276"]}],"id":[{"id":"10.13039\/501100004690","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the effectiveness and safety of laparoscopic sacropexy (LS) and transvaginal mesh (TVM) at 4\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Extended follow up of a randomised trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Eleven centres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with cystocele stage \u22652 (pelvic organ prolapse quantification [POP\u2010Q], aged 45\u201375\u2009years without previous prolapse surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Synthetic non\u2010absorbable mesh placed in the vesicovaginal space and sutured to the promontory (LS) or maintained by arms through pelvic ligaments and\/or muscles (TVM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Functional outcomes (pelvic floor distress inventory [PFDI\u201020] as primary outcome); anatomical assessment (POP\u2010Q), composite outcome of success; re\u2010interventions for complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 220 out of 262 randomised patients have been followed at 4\u2009years. PFDI\u201020 significantly improved in both groups and was better (but below the minimal clinically important difference) after LS (mean difference \u22127.2 points; 95% CI \u221214.0 to \u22120.05; <jats:italic>P<\/jats:italic>\u2009=\u20090.029). The improvement in quality of life and the success rate (LS 70%, 61\u201381% versus TVM 71%, 62\u201381%; hazard ratio 0.92, 95% CI 0.55\u20131.54; <jats:italic>P<\/jats:italic>\u2009=\u20090.75) were similar. POP\u2010Q measurements did not differ, except for point C (LS \u221257\u2009mm versus TVM \u221248\u2009mm, <jats:italic>P<\/jats:italic>\u2009=\u20090.0093). The grade III or higher complication rate was lower after LS (2%, 0\u20134.7%) than after TVM (8.7%, 3.4\u201313.7%; hazard ratio 4.6, 95% CI 1.007\u201321.0, <jats:italic>P<\/jats:italic>\u2009=\u20090.049)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both techniques provided improvement and similar success rates. LS had a better benefit\u2013harm balance with fewer re\u2010interventions due to complications. TVM remains an option when LS is not feasible.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>At 4\u2009years, Laparoscopic Sacropexy (LS) had a better benefit\u2013harm balance with fewer re\u2010interventions due to complications than Trans\u2010Vaginal Mesh (TVM).<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16847","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T10:50:31Z","timestamp":1626346231000},"page":"127-137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Long\u2010term outcomes of primary cystocele repair by transvaginal mesh surgery versus laparoscopic mesh sacropexy: extended follow up of the PROSPERE multicentre randomised trial"],"prefix":"10.1111","volume":"129","author":[{"given":"J\u2010P","family":"Lucot","sequence":"first","affiliation":[{"name":"Service de gyn\u00e9cologie\u2010obst\u00e9trique H\u00f4pital Saint 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