A Randomized Controlled Trial of Laparoscopic Pectopexy versus Sacrocolpopexy for Apical Pelvic Organ Prolapse

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 507–518

DOI: 10.46882/2026/IJOG/000523

Original Research Article

Title: A Randomized Controlled Trial of Laparoscopic Pectopexy versus Sacrocolpopexy for Apical Pelvic Organ Prolapse

Names of Authors: Chidi E. Eze¹, Aisha M. Umar²

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
² Department of Obstetrics and Gynecology, Federal Medical Centre, Katsina, Nigeria

Abstract:
Laparoscopic Sacrocolpopexy (LSC) is the gold standard for apical prolapse repair but can be technically challenging and carries specific risks of bowel interference near the sacral promontory. This randomized controlled trial compared the 2-year anatomical success rates, operative details, and complication profiles of Laparoscopic Pectopexy (LPC)—suspending the vaginal vault to the iliopectineal ligaments—against conventional LSC. One hundred women presenting with symptomatic POP-Q Stage III or IV uterine or vault prolapse were randomized into two equal groups (n = 50 per group). The primary outcome was apical compartment anatomical success (Stage 0 or I) at 24 months. At the 2-year follow-up, anatomical success was achieved in 94.0% of the LPC group and 92.0% of the LSC group, demonstrating therapeutic equivalence (p = 0.68). The mean operative time was significantly shorter in the pectopexy group due to easier suture access (78.4 ± 14.5 minutes vs. 104.6 ± 22.1 minutes, p < 0.001). Furthermore, the incidence of de novo defecation disorders (constipation) was significantly lower in the LPC cohort compared to the LSC cohort (2.0% vs. 14.0%, p = 0.027), secondary to total avoidance of the presacral space. Rates of mesh exposure or dyspareunia did not show structural divergence between the arms (p > 0.05). Laparoscopic pectopexy offers structural durability equivalent to sacrocolpopexy for advanced apical prolapse while reducing operative duration and minimizing postoperative defecation complications.

Keywords: Pelvic Organ Prolapse; Laparoscopic Pectopexy; Sacrocolpopexy; Iliopectineal Ligament; Postoperative Constipation; Apical Suspension.

Manuscript Timeline: Received: June 04, 2026; Revised: July 20, 2026; Accepted: August 04, 2026; Published: August 26, 2026.

Citation: Eze CE, Umar AM. A Randomized Controlled Trial of Laparoscopic Pectopexy versus Sacrocolpopexy for Apical Pelvic Organ Prolapse. International Journal of Obstetrics and Gynecology. 2026; 14(8): 507–518.

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