Effectiveness and safety of surgical procedures to treat apical prolapse - comparison of sacrospinous fixation, laparoscopic sacrocolpopexy/sacrohysteropexy, and the Manchester procedure

Möller A, Campbell J, Forslund M, Hognert H, Rosenberg E, Ödesjö E, Hongslo Vala C, Stadig I, Strandell A, Svanberg T, Wartenberg C
Record ID 32018011321
Authors' objectives: In women receiving surgical treatment of apical prolapse, how do the three surgical methods sacrospinous fixation (SSF), laparoscopic sacrocolpopexy/sacrohysteropexy (LSC/LSH) and Manchester-procedure - compare regarding benefits, risks, and costs? Outcomes critical for decision making: Health related quality of Life (HRQL), awareness of prolapse, patient satisfaction, reoperation, recurrent prolapse. Outcomes important for decision making: dyspareunia, chronic pain, patient-reported tolerance of physical load, and urinary incontinence. Other outcomes: operative time, length of hospital stay, and duration of sick leave. Further, information on complications in connection with the three surgical methods.
Authors' results and conclusions: There are seven studies comparing surgical methods of interest for this HTA-report. The studies comparing sacrospinous fixation and laparoscopic sacrocolpopexy/sacrohysteropexy (LSC/LSH) indicate that there may be little or no difference between these treatments regarding overall HRQL, patient satisfaction, reoperation, relapse, and urinary incontinence. Yet, sacrospinous fixation may imply shorter operative time and may lead to slightly less urogenital distress. For other important outcomes, the available data are insufficient for any inference. Comparative information on sacrospinous fixation and Manchester procedure is limited to one cohort study indicating that reoperation may be less frequent after the Manchester procedure. Currently, no studies comparing laparoscopic sacrocolpopexy/sacrohysteropexy (LSC/LSH) vs the Manchester procedure are available. Regarding risks, urinary tract complications were seen after all three methods. In addition, pelvic, thigh, and gluteal pain were reported after sacrospinous fixation. Cases of venous thromboembolic complications and surgical site infections were seen after laparoscopic sacrocolpopexy/ sacrohysteropexy.
Project Status: Completed
Year Published: 2022
English language abstract: An English language summary is available
Publication Type: Full HTA
MeSH Terms
  • Pelvic Organ Prolapse
  • Minimally Invasive Surgical Procedures
  • Gynecologic Surgical Procedures
  • Laparoscopy
  • Sacrospinous fixation
  • Sacrocolpopexy
  • Sacrohysteropexy
  • Manchester procedure
Organisation Name: The Regional Health Technology Assessment Centre
Contact Address: The Regional Health Technology Assessment Centre, Region Vastra Gotaland, HTA-centrum, Roda Straket 8, Sahlgrenska Universitetssjukhuset, 413 45 GOTHENBORG, Sweden
Contact Name: hta-centrum@vgregion.se
Contact Email: hta-centrum@vgregion.se
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.