A BSTRACT Objectives: Pelvic organ prolapse (POP) is a common condition among women, with various surgical options available, including transvaginal mesh (TVM) and laparoscopic sacropexy (laparoscopy group). This study aimed to compare the 5-year reoperation and recurrence rates between the two procedures. Materials and Methods: Patients with POP who received pelvic reconstruction surgeries, laparoscopy, and TVM, between January 2011 and July 2023, were recruited. The primary outcomes were recurrence, reoperation, mesh erosion rates, and postoperative complications. Secondary outcomes were operative time, blood loss, and hospital stay. Results: A total of 102 patients who underwent pelvic reconstruction with either laparoscopy ( n = 62) or TVM ( n = 40) were analyzed. Baseline characteristics, including age, body mass index, parity, and menopausal status, were similar between groups. Preoperative POP stages differed slightly, with the TVM group having more advanced-stage cases. In the adjusted analysis, TVM showed no significant difference in recurrence (adjusted hazard ratio aHR 0.959, P = 0.171), mesh erosion (aHR 1.739, P = 0.563), blood loss ( P = 0.072), or hospital stay ( P = 0.349) compared with laparoscopy, but it was associated with a significantly lower risk of reoperation (aHR: 0.179, P = 0.032) and shorter operative time (mean difference −142.97 min, P < 0.001). POP-quantification (POP-Q) scores improved significantly in both groups postoperatively. However, laparoscopy demonstrated greater improvement in apical support (point C, P = 0.015), (perineal body, P = 0.028), and (total vaginal length, P = 0.006). Kaplan–Meier analysis showed no significant differences in cumulative reoperation ( P = 0.084) or recurrence ( P = 0.952) rates between groups over 5 years. Conclusion: Both laparoscopy and TVM provided effective pelvic reconstruction with significant postoperative improvement. Laparoscopy offered superior anatomical correction in certain POP-Q parameters, whereas TVM had shorter operative time and lower reoperation risk. Long-term recurrence and reoperation rates were comparable.
Lee et al. (Mon,) studied this question.