Laparoscopic Pectopexy versus Laparoscopic Sacrocolpopexy for Apical Pelvic Organ Prolapse: A Five-Year Prospective Evaluation

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 1107–1118

DOI: 10.46882/2026/IJOG/000573

Original Research Article

Title: Laparoscopic Pectopexy versus Laparoscopic Sacrocolpopexy for Apical Pelvic Organ Prolapse: A Five-Year Prospective Evaluation

Names of Authors: Sofia Rodriguez¹, Arthur Pendelton²

Authors’ Affiliations:
¹ Departamento de Ginecología, Hospital Universitario La Paz, Madrid, Spain
² Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA

Abstract:
Laparoscopic Sacrocolpopexy (LSC) is a gold-standard approach for apical prolapse repair, but presacral space dissection introduces risks of hypogastric nerve injury and defecation disorders. Laparoscopic Pectopexy (LPC)—vault suspension to the iliopectineal ligaments—avoids the presacral arena entirely. This prospective longitudinal cohort study compared the 5-year anatomical durability, operational safety, and long-term complication profiles of LPC versus conventional LSC. One hundred women presenting with symptomatic POP-Q Stage III or IV apical prolapse were assigned to undergo either LPC (n = 50) or LSC (n = 50) and tracked for 60 months. At the 5-year mark, apical anatomical success (Stage 0 or I) was maintained in 92.0% of the LPC cohort and 90.0% of the LSC cohort, demonstrating clinical equivalence (p = 0.74). However, the incidence of de novo long-term constipation was significantly lower in the pectopexy group compared to the sacrocolpopexy group (2.0% vs. 16.0%, p = 0.014). Long-term mesh exposure or dyspareunia rates did not vary between the arms (4.0% vs. 6.0%, p = 0.65). Mean surgical durations were significantly shorter for the pectopexy installation (76.5 ± 14.2 minutes vs. 102.4 ± 18.5 minutes, p < 0.001). Laparoscopic pectopexy offers long-term apical structural durability equivalent to sacrocolpopexy while optimizing operative durations and minimizing chronic postoperative bowel complications.

Keywords: Pelvic Organ Prolapse; Laparoscopic Pectopexy; Sacrocolpopexy; Iliopectineal固定; Postoperative Constipation; Long-Term Success.

Manuscript Timeline: Received: July 22, 2026; Revised: September 10, 2026; Accepted: September 22, 2026; Published: September 29, 2026.

Citation: Rodriguez S, Pendelton A. Laparoscopic Pectopexy versus Laparoscopic Sacrocolpopexy for Apical Pelvic Organ Prolapse: A Five-Year Prospective Evaluation. International Journal of Obstetrics and Gynecology. 2026; 14(9): 1107–1118.

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