Efficacy of Robotic Apical Suspension versus Vaginal Native Tissue Repair for Advanced Uterine Prolapse

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 1047–1058

DOI: 10.46882/2026/IJOG/000568

Original Research Article

Title: Efficacy of Robotic Apical Suspension versus Vaginal Native Tissue Repair for Advanced Uterine Prolapse

Names of Authors: Giuseppe Bianchi¹, Lin-Wei Chen²

Authors’ Affiliations:
¹ Department of Gynecology, University of Milan, Milan, Italy
² Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan

Abstract:
Advanced pelvic organ prolapse significantly compromises the structural quality of life in postmenopausal women. This prospective comparative study evaluated the 2-year anatomical durability and functional outcomes of Robotic Sacrocolpopexy (RSC) relative to Vaginal Native Tissue Repair (VNTR) via sacrospinous ligament fixation. One hundred and forty postmenopausal patients presenting with symptomatic Stage III or IV apical uterine prolapse were assigned to undergo either RSC (n = 70) or VNTR (n = 70). The primary endpoint measured was objective anatomical success, defined as Pelvic Organ Prolapse Quantification (POP-Q) stage 0 or I at the apical compartment 24 months post-surgery. At 2 years, RSC demonstrated a significantly higher objective success rate compared to the VNTR group (94.3% vs. 81.4%, p = 0.018). Subjective symptom scores on the Pelvic Floor Distress Inventory (PFDI-20) showed marked, equivalent improvements across both surgical branches (p < 0.001). However, the VNTR group experienced higher rates of anterior compartment recurrence requiring minor revision (14.3% vs. 2.9%, p = 0.022). Total operative duration was significantly longer in the robotic cohort (114.5 ± 22.4 minutes vs. 54.2 ± 12.8 minutes, p < 0.001), but it yielded lower rates of transient postoperative voiding dysfunction (p = 0.034). Robotic sacrocolpopexy provides superior long-term anatomical durability and a lower recurrence profile for advanced apical uterine prolapse compared to native vaginal tissue suspension despite longer initial operative timelines.

Keywords: Pelvic Organ Prolapse; Robotic Sacrocolpopexy; Native Tissue Repair; Apical Suspension; Recurrence Rate; Urogynecology.

Manuscript Timeline: Received: July 10, 2026; Revised: September 02, 2026; Accepted: September 14, 2026; Published: September 25, 2026.

Citation: Bianchi G, Chen LW. Efficacy of Robotic Apical Suspension versus Vaginal Native Tissue Repair for Advanced Uterine Prolapse. International Journal of Obstetrics and Gynecology. 2026; 14(9): 1047–1058.

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