Situational-factors-driven recurrence rate of laparoscopic sacropexy in genital prolapse

Introduction. Laparoscopic sacropexy is widely used for the treatment of pelvic organ prolapse (РОР). The safety and efficacy of this procedure have been studied in many countries, but the causes of recurrence are not fully understood. Aim: to evaluate frequency of adverse outcomes 12 months postoperative laparoscopic sacropexy and to identify associated risk factors. Materials and Methods. The observational prospective controlled non-randomized study was conducted at the Surgical Clinic of Azerbaijan Medical University (AMU). A total of 235 patients who underwent surgery at the clinic from 2013 to 2023 were included in a consecutive observational cohort. All patients were examined preoperatively and at 1, 6, and 12 months postoperatively using the Pelvic Organ Prolapse Quantification (POP-Q) system. All major postoperative complications and recurrences were recorded as they occurred. Results. During the 12-month follow-up, the overall recurrence rate was 29.5 ± 2.9 %. The need for repeat surgery peaked among patients with a preoperative Ba measurement of −2 cm (12.5 ± 8.2 %). A high rate of reoperations was also observed in patients with a preoperative Ba measurement of +3 cm (11.9 ± 6.9 %; 95 % confidence interval (CI) = 2.1–21.8 %). Reoperation rates below 2.1 % were observed in women with diverse situational factors – age < 50 years, premenopausal status, body mass index (BMI) < 25 kg/m², baseline Ba −2 and −1, etc. The maximum frequency of apical recurrences was 11.5 ± 3.6 % (95 % CI = 4.3–18.7 %) and occurred in patients whose preoperative D measurement ranged from −3 to +3 cm. Conclusion. The recurrence rate after laparoscopic sacropexy varies and depends on the clinical profile of the patients. The risk of postoperative recurrence after laparoscopic sacropexy increases significantly with patient age, higher body mass index, onset of menopause, and unfavorable preoperative prolapse characteristics according to the Pelvic Organ Prolapse Quantification (POP-Q) system