ArticleBMC women's health2026
Single-port laparoscopic lateral suspension with total versus subtotal hysterectomy for pelvic organ prolapse: a prospective comparative study.
Article in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLaparoscopic lateral suspension (LLS) is an effective mesh-based repair for pelvic organ prolapse (POP), but the optimal concomitant hysterectomy strategy - total (TH) versus subtotal (STH) - remains undefined. We compared anatomic outcomes, patient-reported outcomes, and complication profiles of LLS combined with TH (LLSHR) versus LLS combined with STH (LLSHE) in a prospective cohort of women who made an informed choice between the two procedures.
methodsIn this prospective comparative study conducted at Chengdu Integrated TCM & Western Medicine Hospital between October 2021 and October 2024, 82 women with symptomatic POP-Q stage II or III uterovaginal prolapse were counseled regarding both hysterectomy options and self-selected into the LLSHR group (n = 41) or the LLSHE group (n = 41). The study was approved by the institutional review board (IRB 2021.XJS.019) and retrospectively registered in the Chinese Clinical Trial Registry (ChiCTR2600118158). Primary outcomes were POP-Q point C and PISQ-12 score at 12 months. Secondary outcomes included POP-Q points Ba and Bp, PFDI-20, PFIQ-7, operative parameters, and mesh-related complications through 24 months.
resultsAll 82 participants completed surgery as planned. At 12 months, point C was significantly more negative in the LLSHE group than in the LLSHR group (- 5.1 ± 0.5 cm vs. -4.5 ± 0.6 cm; P < 0.001), indicating superior apical support with cervical preservation. The PISQ-12 score at 12 months was significantly higher (better) in the LLSHE group (37.5 [IQR 33.0-42.5] vs. 31.0 [27.0-34.0]; P < 0.001). PFDI-20 and PFIQ-7 improved substantially in both groups with no between-group difference at any time point (all P > 0.05). At 24 months, point C remained significantly more negative in the LLSHE group (- 4.8 ± 0.5 vs. -4.4 ± 0.6; P = 0.004), and the PISQ-12 advantage of LLSHE persisted (37.0 [34.0-43.0] vs. 31.5 [26.8-39.0]; P = 0.005). Mesh exposure was observed in 3 patients (9.4%) in the LLSHR group and none in the LLSHE group (P = 0.226). Operative time was significantly shorter in the LLSHE group (149.0 [143.0-165.0] min vs. 171.0 [150.0-186.0] min; P = 0.002).
conclusionsIn women undergoing LLS for POP, STH was associated with superior apical support and better sexual function at both 12 and 24 months, with shorter operative time and a numerically lower rate of mesh exposure compared with TH. Given the non-randomized design, these findings should be interpreted as hypothesis-generating. Prospective randomized trials are warranted to confirm these associations.
trial registrationChiCTR2600118158; registered February 2, 2026, retrospectively registered.
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