ArticleInternational urogynecology journal2026
Sacrospinous Hysteropexy Versus Vaginal Hysterectomy in Women with Uterine Prolapse: 10-year Follow-up of a Randomised Controlled Trial.
Article in International urogynecology journal, 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
introduction and hypothesisOne-year results from the SAVE U trial showed that sacrospinous hysteropexy (SSH) was non-inferior to vaginal hysterectomy with uterosacral ligament suspension (VH) and 5-year follow-up favoured SSH for apical outcomes. Because long-term follow-up comparing these surgical procedures is lacking, it is unknown whether these outcomes remain stable over time.
methodsThis 10-year follow-up of the SAVE U randomised controlled trial compared SSH with VH with uterosacral ligament suspension in women with uterine prolapse with uterine descent stage ≥2. The primary outcome was surgical failure of the apical compartment, defined as recurrent prolapse stage ≥2 of the uterus or vaginal vault combined with bothersome bulge symptoms or repeat surgery for recurrent apical prolapse. Secondary outcomes included surgical failure in any compartment, overall anatomical failure, a composite outcome of success, functional outcomes, and quality of life.
resultsAt 10 years, surgical failure of the apical compartment occurred in 3 out of 44 women (7%) after SSH and 7 out of 49 (14%) after VH with uterosacral ligament suspension (difference -6.6%, 95% CI -19.9% to 6.7%). Posterior compartment failure was less frequent after SSH (11.6% vs 52.2%; difference -37.1%, 95% CI -54.3% to -19.9%). Obstructive micturition scores were poorer after SSH despite median scores of zero in both groups owing to a skewed distribution (median 0 [IQR 0-33.3] vs 0 [0-0], p = 0.01). Other secondary outcomes did not differ significantly.
conclusionNo significant differences were found between SSH and VH with uterosacral ligament suspension in surgical failure at 10 years' follow-up. However, the reduced sample size may limit the ability to detect significant differences. Furthermore, posterior compartment outcomes favoured SSH, whereas obstructive voiding symptoms favoured VH.
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