Surgical treatment for apical vaginal prolapse: sacrocolpopexy, sacrohysteropexy, and sacrospinous fixation

Pelvic organ prolapse is the downward displacement of a pelvic organ. It is a frequently occurring health issue, which can cause various symptoms affecting the quality of life. This thesis investigated which surgery offers the most optimal treatment for women with uterine prolapse or vaginal vault prolapse (after the uterus has been removed). One year postoperatively there is no substantial difference between an abdominal surgery with mesh (sacrocolpopexy or sacrohysteropexy) compared with a vaginal surgery (sacrospinous fixation). Both are effective treatment options for women with uterine prolapse or vaginal vault prolapse. This thesis also provided evidence that sacrocolpopexy is best performed with laparoscopy in stead of an open abdominal surgery. There is less blood loss during surgery and the hospital stay is shorter. Results after one year and after long-term are comparable in terms of effectiveness and quality of life.