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Retrospective cohort of 28 women with advanced apical prolapse undergoing mesh-based laparoscopic lateral suspension combined with uterosacral ligament suspension.

Retrospective cohort of 28 women with advanced apical prolapse undergoing mesh-based laparoscopic la…
Photo by Aakash Dhage / Unsplash
Key Takeaway
Note preliminary safety in 28 women but lack of reported efficacy data limits clinical application for advanced apical prolapse.

This preliminary retrospective cohort study examined 28 women diagnosed with apical pelvic organ prolapse (POP) at stage III or higher. The patients received mesh-based laparoscopic lateral suspension (LLS) combined with uterosacral ligament suspension (USLS) using Titanized polypropylene mesh. The study setting was not reported, and no comparator group was included. Primary outcomes focused on objective anatomic success defined as POP-Q stage 0, though specific results for this metric were not reported in the available data. Secondary outcomes assessed serious complications and mesh exposure.

During the short-term follow-up period, no serious complications were observed, with absolute numbers recorded as 0. Similarly, there were no instances of mesh exposure reported. The safety profile appeared tolerable within this limited timeframe. However, the study design precluded the calculation of effect sizes or confidence intervals for the primary anatomic outcome. The absence of a control group and potential confounding effects from distal vaginal repairs represent significant limitations in interpreting the results.

The findings suggest this approach may be a potentially effective treatment for advanced, multi-compartment apical prolapse. Nevertheless, caution is advised regarding long-term durability and efficacy specifically for advanced apical defects with posterior compartment involvement. These conclusions remain preliminary due to the observational nature of the study and the small sample size. Further research is needed to validate these early outcomes.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundLaparoscopic lateral suspension (LLS) is a novel technique for repairing anterior and apical pelvic organ prolapse (POP). However, the efficacy is limited for advanced apical defects, particularly when combined with posterior compartment prolapse. This preliminary study evaluated the short-term outcomes of mesh-based LLS combined with uterosacral ligament suspension (USLS) for treating advanced apical prolapse with involvement of both the anterior and posterior compartments.MethodsBetween January 2022 and June 2024, 28 women with apical POP ≥ stage III underwent mesh-based LLS with USLS. Titanized polypropylene mesh was placed on the vesicovaginal fascia, and the posterior compartment defects were addressed with USLS. All patients preserved their uterus. Clinical outcomes were assessed using the gynecological examination and the pelvic organ prolapse quantification (POP-Q) system. Objective anatomic success was defined as POP-Q stage  0.05). No serious complications or mesh exposure occurred.ConclusionCombining LLS with USLS is a safe and potentially effective treatment for advanced, multi-compartment apical prolapse in this preliminary cohort. While short-term outcomes are encouraging, the lack of a control group and the potential confounding effect of distal vaginal repair necessitate larger studies to confirm long-term durability.
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