Post-hysterectomy Vaginal Cuff Prolapse Repair

This study is a randomized controlled trial (RCT) designed to compare the outcomes of two minimally invasive surgical techniques-laparoscopic lateral suspension and laparoscopic sacrocolpopexy-for the treatment of vaginal cuff prolapse following hysterectomy. Vaginal cuff prolapse occurs when the top of the vagina loses its normal support after the uterus has been removed, leading to symptoms such as a sensation of vaginal bulging, pelvic pressure, urinary or bowel dysfunction, and discomfort during daily activities or sexual intercourse.

Eligible participants are women who have previously undergone hysterectomy and are experiencing symptomatic vaginal cuff prolapse. Participants will be randomly assigned to undergo either laparoscopic lateral suspension or laparoscopic sacrocolpopexy. Both procedures are performed using minimally invasive laparoscopic techniques, which typically result in smaller incisions, less pain, and faster recovery compared to traditional open surgery.

The study will assess multiple clinical and patient-reported outcomes, including:

Anatomical success: Prevention of prolapse recurrence at follow-up visits.

Functional outcomes: Improvement in urinary, bowel, and sexual function.

Complications: Intraoperative and postoperative adverse events.

Recovery metrics: Length of hospital stay, return to daily activities, and postoperative pain.

Patient satisfaction: Quality of life and overall satisfaction with the procedure.

By conducting this study, researchers aim to provide evidence-based guidance on which surgical approach offers better long-term outcomes, fewer complications, and higher patient satisfaction. The results of this trial may help clinicians make informed decisions and improve the care of women with post-hysterectomy vaginal cuff prolapse.

Inclusion criteria

Women aged ≥18 years.

History of hysterectomy (any approach: abdominal, vaginal, or laparoscopic).

Symptomatic vaginal cuff prolapse (POP-Q stage ≥ II).

Able to provide written informed consent.

Willing and able to comply with study procedures and follow-up visits.

Exclusion criteria

Prior sacrocolpopexy or lateral suspension surgery.

Active pelvic infection or untreated malignancy.

Severe cardiopulmonary or systemic disease that contraindicates laparoscopic surgery.

Known allergy to mesh materials used in the procedures.

Inability to complete patient-reported questionnaires due to cognitive or language barriers.

Concurrent pelvic organ prolapse requiring additional surgical repair beyond vaginal cuff suspension.