Laparoscopic Sacropexy Versus Vaginal Sacrospinous Fixation for Pelvic Organ Prolapse: A Retrospective Comparison of Surgical Outcomes and Quality of Life.

Background: Pelvic organ prolapse (POP) significantly impacts women's quality of life. Two established surgical approaches exist: laparoscopic sacropexy (LSC) and vaginal sacrospinous fixation (SSLF). This study compared surgical outcomes, complication rates, and quality of life between these techniques. Methods: This retrospective monocentric study included 58 patients treated between 2020 and 2023: 41 underwent LSC, and 17 underwent SSLF with vaginal hysterectomy. All procedures were performed by a single surgeon. Primary outcomes included operative time, complications, and hospital stay. Quality of life was assessed using the German Pelvic Floor Questionnaire (Deutscher Beckenboden-Fragebogen), King's Health Questionnaire (KHQ), and patient satisfaction surveys. Results: Patient groups differed significantly in ASA scores (p = 0.023) and comorbidities, with SSLF patients showing higher morbidity. LSC demonstrated longer operative times (91 (75-115) vs. 73 (61-87) min, p = 0.05) but significantly fewer complications (0% vs. 17.6%, p = 0.02). Both methods showed significant improvements in bladder function, prolapse symptoms, and pelvic floor dysfunction scores (all p < 0.001). A within-group improvement in sexual function scores was observed in the LSC group (p = 0.002) but not in the SSLF group (p = 0.5); the between-group comparison of change scores was not significant (p = 0.8). No significant differences were found between groups regarding hospital stay duration or overall patient satisfaction (LSC: 95% vs. SSLF: 87% satisfied, p > 0.05). Conclusions: Both surgical approaches effectively treat POP with high patient satisfaction. LSC was associated with fewer observed complications and a within-group improvement in sexual function scores; SSLF was associated with shorter operative time and was applied in patients with higher morbidity. These associations may partly reflect baseline differences between groups and are considered hypothesis-generating. SSLF remains suitable for patients with higher morbidity when minimizing operative time and avoiding Trendelenburg positioning is advantageous.