title: Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial.
abstract: OBJECTIVE
  To compare the laparoscopic sacral colpopexy and total vaginal mesh for vaginal vault prolapse.
  
  
  METHODS
  Women with symptomatic stage ≥2 vault prolapse were randomly allocated the laparoscopic sacral colpopexy (53) or total vaginal mesh (55). Primary outcome measures were objective success rates at pelvic organ prolapse quantification sites individually and collectively. Secondary outcome measures included perioperative outcomes, patient satisfaction, quality of life outcomes, complications, and reoperations.
  
  
  RESULTS
  The laparoscopic sacral colpopexy group had a longer operating time, reduced inpatient days, and quicker return to activities of daily living as compared with the total vaginal mesh group. At the 2-year review, the total objective success rate at all vaginal sites was 41 of 53 (77%) for laparoscopic sacral colpopexy as compared with 23 of 55 (43%) in total vaginal mesh (P < .001). Reoperation rate was significantly higher after the vaginal mesh surgery 12 of 55 (22%) as compared with laparoscopic sacral colpopexy 3 of 53 (5%) (P = .006).
  
  
  CONCLUSIONS
  At 2 years, the laparoscopic sacral colpopexy had a higher satisfaction rate and objective success rate than the total vaginal mesh with lower perioperative morbidity and reoperation rate.
authors.affiliation: Wesley, Royal Brisbane, and Mater Urogynaecology, Brisbane, Queensland, Australia. chrismaher@urogynaecology.com.au
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Maher
authors.forename: Benjamin
authors.initials: B
authors.lastname: Feiner
authors.forename: Eva M
authors.initials: EM
authors.lastname: DeCuyper
authors.forename: Cathy J
authors.initials: CJ
authors.lastname: Nichlos
authors.forename: Kacey V
authors.initials: KV
authors.lastname: Hickey
authors.forename: Peter
authors.initials: P
authors.lastname: O'Rourke
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D020127:Recovery of Function; D012086:Reoperation / Q000706:statistics & numerical data; D012447:Sacrum; D013526:Surgical Mesh; D013997:Time Factors; D014596:Uterine Prolapse / Q000601:surgery*