Prospective multicentre registry study on sacropexy using the semitendinosus tendon for apical prolapse repair: an interim analysis

ABSTRACT Study Objective Pelvic organ prolapse (POP) affects more than 40% of parous women. This registry study evaluates clinical and patient-reported outcomes of minimally invasive sacropexy using the autologous semitendinosus tendon for apical prolapse repair. Design Prospective multicentre registry interim analysis. Setting Six centres for minimally invasive pelvic floor surgery in Germany, Austria, and Switzerland. Participants Patients with symptomatic apical POP (POP-Q ≥1) undergoing laparoscopic or robotic-assisted sacropexy between March 2023 and September 2025 (n=514). Interventions Sacropexy was performed using an autologous semitendinosus tendon graft. Measurements Outcomes were assessed at discharge, 3 months (FU3), and 12 months (FU12) using POP-Q staging and the validated German Pelvic Floor Questionnaire (GPFQ). Anatomical correction (POP-Q points Ba, Bp, C), complication rates, reoperation for POP, and patient-reported pelvic floor symptoms (GPFQ). Main Results Median age was 62 years and median BMI 24.2 kg/m²; 8.9% had previous POP surgery. Mean tendon harvesting time was 7 minutes and mean hospital stay 4 days. Intraoperative complications occurred in 3.5% and postoperative complications in 5.3%. POP-Q points Ba, Bp, and C improved significantly at all follow-ups (all p<0.05). Reoperation for POP occurred in 3.9% by FU12 without clinically relevant apical recurrence. All GPFQ domains improved significantly (total score 12.3 preoperatively vs. 4.5 at FU3 and 5.4 at FU12; p<0.001). Stress urinary incontinence symptoms decreased significantly. Conclusions Autologous semitendinosus sacropexy is a safe minimally invasive alternative to mesh-based repair, providing excellent anatomical outcomes and significant quality-of-life improvement at mid-term follow-up.