{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:38:50Z","timestamp":1793295530965,"version":"4.5.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T00:00:00Z","timestamp":1646352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Laparoscopic sacral colpopexy is the gold standard technique for apical prolapse correction but it is a technically challenging procedure with rare but severe morbidity. Laparoscopic high uterosacral ligament suspension could be a valid technically easier alternative using native tissue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>In the period from 2015 to 2018, 600 women were submitted to laparoscopic sacral colpopexy while 150 to laparoscopic high uterosacral ligament suspension in three Italian urogynecology referral centers. We enrolled women with apical prolapse stage \u22652 alone or multicompartment descensus. To reduce allocation bias, we performed a propensity matched analysis. Women undergoing laparoscopic high uterosacral ligament suspension surgery were matched 1:2 to women undergoing laparoscopic sacral colpopexy. The cumulative proportion of relapse-free women in time was analyzed by the Kaplan\u2013Meier method. The primary objective of this multicenter case-control retrospective study was to compare the recurrence rate while the secondary objectives were to compare feasibility, safety, and efficacy of laparoscopic sacral colpopexy and laparoscopic high uterosacral ligament suspension in surgical treatment of pelvic organ prolapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three hundred and nine women were enrolled (103 laparoscopic high uterosacral ligament suspension; 206 laparoscopic sacral colpopexy). Median operatory time was significantly shorter in the laparoscopic high uterosacral ligament suspension group (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0001). No statistically significative difference was found in terms of estimated blood loss, admission time, intraoperative, and major early postoperative complications, postoperative pelvic pain, dyspareunia and\n                      <jats:italic>de novo<\/jats:italic>\n                      stress urinary incontinence. Surgical approach was the only independent risk factor for prolapse recurrence (RR = 6.013 [2.965\u201312.193],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0001). The objective cure rate was higher in the laparoscopic sacral colpopexy group (93.7 vs. 68%, 193\/206 vs. 70\/103,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0001) with a highly reduced risk of recurrence (RR = 5.430 [1.660\u201317.765]). Median follow up was 22 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both techniques are safe, feasible, and effective. Laparoscopic sacral colpopexy remains the best choice in treatment of multicompartment and advanced pelvic organ prolapse while laparoscopic high uterosacral ligament suspension could be appropriate for moderate and isolated apical prolapse when laparoscopic sacral colpopexy is not suitable for the patient or to prevent prolapse in women at high risk at the time of the hysterectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2022.853694","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T23:50:17Z","timestamp":1646351417000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Laparoscopic High Uterosacral Ligament Suspension vs. Laparoscopic Sacral Colpopexy for Pelvic Organ Prolapse: A Case-Control Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Giuseppe","family":"Campagna","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Vacca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Panico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Vizzielli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Caramazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Zaccoletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monia","family":"Marturano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Granese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Arcieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Cianci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Ercoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1002\/nau.22922","article-title":"An International Urogynecological Association (IUGA) \/ International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Organ Prolapse (POP): International Urogynecological Association (IUGA)","volume":"35","author":"Haylen","year":"2016","journal-title":"Neurourol Urodyn."},{"key":"B2","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1067\/mob.2002.125704","article-title":"The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the international continence society","volume":"187","author":"Abrams","year":"2002","journal-title":"Am J Obstetr Gynecol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.ajog.2003.07.017","article-title":"Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women","volume":"190","author":"Handa","year":"2004","journal-title":"Am J Obstetr Gynecol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.ajog.2010.12.024","article-title":"Body image perceptions in women with pelvic organ prolapse: a qualitative study","volume":"204","author":"Lowder","year":"2011","journal-title":"Am J Obstetr Gynecol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1016\/j.ajog.2006.01.060","article-title":"Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life","volume":"194","author":"Jelovsek","year":"2006","journal-title":"Am J Obstetr Gynecol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1007\/s00192-013-2169-9","article-title":"Epidemiology and outcome assessment of pelvic organ prolapse","volume":"24","author":"Barber","year":"2013","journal-title":"Int Urogynecol J."},{"key":"B7","doi-asserted-by":"publisher","first-page":"CD004014","DOI":"10.1002\/14651858.CD004014.pub5","article-title":"Surgical management of pelvic organ prolapse in women","volume":"30","author":"Maher","year":"2013","journal-title":"Cochrane Database Syst Rev."},{"key":"B8","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/S0029-7844(97)00058-6","article-title":"Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence","volume":"89","author":"Olsen","year":"1997","journal-title":"Obstetr Gynecol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1016\/j.urology.2015.08.022","article-title":"Trends in mesh use for pelvic organ prolapse repair from the medicare database","volume":"86","author":"Wang","year":"2015","journal-title":"Urology."},{"key":"B10","unstructured":"Urogynecologic Surgical Mesh Implants."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1007\/s00192-011-1539-4","article-title":"Risks, symptoms, and management of pelvic nerve damage secondary to surgery for pelvic organ prolapse: a report of 95 cases","volume":"22","author":"Possover","year":"2011","journal-title":"Int Urogynecol J."},{"key":"B12","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1097\/01.AOG.0000139514.90897.07","article-title":"Abdominal sacrocolpopexy: a comprehensive review","volume":"104","author":"Nygaard","year":"2004","journal-title":"Obstetr Gynecol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1007\/s00192-014-2407-9","article-title":"Laparoscopic uterosacral ligament suspension and sacral colpopexy: results and complications","volume":"25","author":"Filmar","year":"2014","journal-title":"Int Urogynecol J."},{"key":"B14","first-page":"273","article-title":"Uterosacral colpopexy at the time of vaginal hysterectomy: comparison of laparoscopic and vaginal approaches","volume":"54","author":"Rardin","year":"2009","journal-title":"J Reprod Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1007\/s00192-015-2897-0","article-title":"Comparison of complications and prolapse recurrence between laparoscopic and vaginal uterosacral ligament suspension for the treatment of vaginal prolapse","volume":"27","author":"Turner","year":"2016","journal-title":"Int Urogynecol J."},{"key":"B16","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1097\/SPV.0000000000000306","article-title":"Subjective and objective outcomes of robotic and vaginal high uterosacral ligament suspension","volume":"22","author":"Vallabh-Patel","year":"2016","journal-title":"Female Pelvic Med Reconstr Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/j.jmig.2005.03.014","article-title":"Laparoscopic vaginal vault suspension using uterosacral ligaments: a review of 133 cases","volume":"12","author":"Lin","year":"2005","journal-title":"J Minim Invasive Gynecol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/j.ajog.2015.11.005","article-title":"Estimated levator ani subtended volume: a novel assay for predicting surgical failure after uterosacral ligament suspension","volume":"214","author":"Wyman","year":"2016","journal-title":"Am J Obstetr Gynecol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.ajog.2017.09.015","article-title":"Prolapse recurrence following sacrocolpopexy vs uterosacral ligament suspension: a comparison stratified by Pelvic Organ Prolapse Quantification stage","volume":"218","author":"Lavelle","year":"2018","journal-title":"Am J Obstetr Gynecol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1002\/nau.23106","article-title":"Laparoscopic sacral colpopexy: how to place the posterior mesh into rectovaginal space?","volume":"36","author":"Lizee","year":"2017","journal-title":"Neurourol Urodyn."},{"key":"B21","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.ejogrb.2017.12.043","article-title":"Laparoscopic supracervical hysterectomy and sacral colpopexy for pelvic organ prolapse with percutaneous surgical system: results from a pilot study","volume":"221","author":"Campagna","year":"2018","journal-title":"Eur J Obstetr Gynecol Reprod Biol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1016\/j.jmig.2017.03.008","article-title":"Laparoscopic nerve-preserving sacropexy","volume":"24","author":"Ercoli","year":"2017","journal-title":"J Minim Invasive Gynecol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1007\/s00192-018-3588-4","article-title":"Laparoscopic high uterosacral ligament suspension: an alternative route for a traditional technique","volume":"29","author":"Panico","year":"2018","journal-title":"Int Urogynecol J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann Surg."},{"key":"B25","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1002\/nau.22238","article-title":"An international urogynecological association (IUGA)\/international continence society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse","volume":"31","author":"Toozs-Hobson","year":"2012","journal-title":"Neurourol Urodyn."},{"key":"B26","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s00192-009-1069-5","article-title":"Validation of the Patient Global Impression of Improvement (PGI-I) for urogenital prolapse","volume":"21","author":"Srikrishna","year":"2010","journal-title":"Int Urogynecol J."},{"key":"B27","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1080\/01621459.1984.10478078","article-title":"Reducing bias in observational studies using subclassification on the propensity score","volume":"79","author":"Rosenbaum","year":"1984","journal-title":"J Am Stat Assoc."},{"key":"B28","doi-asserted-by":"publisher","first-page":"757","DOI":"10.7326\/0003-4819-127-8_Part_2-199710151-00064","article-title":"Estimating causal effects from large data sets using propensity scores","volume":"127","author":"Rubin","year":"1997","journal-title":"Ann Intern Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/00273171.2011.568786","article-title":"An introduction to propensity score methods for reducing the effects of confounding in observational studies","volume":"46","author":"Austin","year":"2011","journal-title":"Multivariate Behav Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1402","DOI":"10.1067\/mob.2000.111298","article-title":"Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse","volume":"183","author":"Barber","year":"2000","journal-title":"Am J Obstetr Gynecol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1007\/s00192-018-3801-5","article-title":"Uterosacral vault suspension (USLS) at the time of hysterectomy: laparoscopic versus vaginal approach","volume":"30","author":"Houlihan","year":"2019","journal-title":"Int Urogynecol J."},{"key":"B32","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1097\/SPV.0000000000000202","article-title":"Ureteral compromise in laparoscopic versus vaginal uterosacral ligament suspension: a retrospective cohort","volume":"21","author":"Barbier","year":"2015","journal-title":"Female Pelvic Med Reconstr Surg."},{"key":"B33","doi-asserted-by":"publisher","first-page":"2016","DOI":"10.1001\/jama.2013.4919","article-title":"Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse","volume":"309","author":"Nygaard","year":"2013","journal-title":"JAMA."},{"key":"B34","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1097\/AOG.0b013e3181778d2a","article-title":"Two-year outcomes after sacrocolpopexy with and without burch to prevent stress urinary incontinence","volume":"112","author":"Brubaker","year":"2008","journal-title":"Obstetr Gynecol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.ejogrb.2016.07.503","article-title":"Sacrocolpopexy for pelvic organ prolapse: evidence-based review and recommendations","volume":"205","author":"Costantini","year":"2016","journal-title":"Eur J Obstetr Gynecol Reprod Biol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1007\/s00192-016-3149-7","article-title":"De novo stress urinary incontinence after pelvic organ prolapse surgery in women without occult incontinence.","volume":"28","author":"Alas","year":"2017","journal-title":"Int Urogynecol J."},{"key":"B37","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1097\/SPV.0000000000000446","article-title":"Anatomical outcome and patient satisfaction after laparoscopic uterosacral ligament hysteropexy for anterior and apical prolapse","volume":"24","author":"Haj Yahya","year":"2018","journal-title":"Female Pelvic Med Reconstr Surg."},{"key":"B38","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.jmig.2019.02.012","article-title":"Laparoscopic uterosacral ligament hysteropexy vs total vaginal hysterectomy with uterosacral ligament suspension for anterior and apical prolapse: surgical outcome and patient satisfaction","volume":"27","author":"Haj-Yahya","year":"2020","journal-title":"J Minim Invasive Gynecol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"CD004014","DOI":"10.1002\/14651858.CD004014.pub6","article-title":"Surgery for women with anterior compartment prolapse","volume":"11","author":"Maher","year":"2016","journal-title":"Cochrane Database Syst Rev."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.853694\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T23:50:21Z","timestamp":1646351421000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.853694\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,4]]},"references-count":39,"alternative-id":["10.3389\/fmed.2022.853694"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.853694","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,4]]},"article-number":"853694"}}