Study Suggests Lateral Suspension May Rival Gold Standard for Pelvic Prolapse Repair

A New Contender in Pelvic Organ Prolapse Surgery

Pelvic organ prolapse (POP) affects over 40% of women, often leading to discomfort, lifestyle disruptions, and surgery for many. Traditionally, sacral colpopexy (SCP)—especially via minimally invasive laparoscopy—has been considered the gold standard for correcting prolapse at the top (apex) of the vagina. However, SCP’s extended operative time and risks tied to deep pelvic dissection have prompted surgeons to explore alternatives. Enter lateral suspension (LLS)—a technique designed to be faster, less invasive, and easier to learn, but does it live up to the gold standard?

What Did the Study Examine?

A systematic review and meta-analysis published in the Archives of Gynecology and Obstetrics dove into this question. Researchers pooled data from six studies (including randomized trials and observational cohorts, totaling 632 women) comparing laparoscopic sacral colpopexy (LSCP) and laparoscopic lateral suspension (LLS).

Key Findings: Success Rates and Recovery

Effectiveness: Both LSCP and LLS had similar success rates for fixing apical and anterior vaginal wall prolapse, with no significant difference in outcomes.

Surgical Time: Lateral suspension was much quicker, shaving an average of 43 minutes off the operating time compared to LSCP.

Complications & Recurrence: Rates of complications, need for re-operation, and relapse were comparable between the two procedures.

Quality of Life: Both techniques improved sexual function and had low rates of new urinary or bowel issues after surgery.

Pain: LLS had a slightly higher—but not statistically significant—rate of post-surgical pain, often at the mesh fixation site, while LSCP was more associated with back pain.

What Does This Mean for Patients?

For women and their surgeons, these findings are promising. Lateral suspension offers a less complex, potentially faster alternative to sacral colpopexy, with similar results for many patients. However, most of the evidence comes from women with less advanced prolapse and short-to-medium-term follow-up. More research is needed for advanced cases and to understand long-term durability.

5 Key Takeaways:

LSCP and LLS are equally effective for treating many cases of pelvic organ prolapse.

LLS shortens surgery time without raising the risk of complications or recurrence.

Both approaches improve quality of life and sexual function after surgery.

Pain profiles differ, with LLS linked to localized mesh discomfort and LSCP to back pain.

Long-term studies and trials in advanced cases are needed before LLS can be called a full equivalent to LSCP.

Citation:

Lombisani, A., Tius, V., Ferraro, C., et al. (2025). Lateral suspension vs. sacral colpopexy for treating pelvic organ prolapse: a systematic review and meta-analysis. Archives of Gynecology and Obstetrics, 312, 1891–1900. https://doi.org/10.1007/s00404-025-08210-4