Observational studyBMJ (Clinical research ed.)2019
Sacrospinous hysteropexy versus vaginal hysterectomy with uterosacral ligament suspension in women with uterine prolapse stage 2 or higher: observational follow-up of a multicentre randomised trial.
Observational study in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Effect of different surgical techniques on postoperative wound infection in patients with uterine prolapse: A meta-analysis.International wound journal · 2024Pooled it
- Surgery for women with apical vaginal prolapse.The Cochrane database of systematic reviews · 2023Pooled it
- Economic evaluation of Manchester procedure versus sacrospinous hysteropexy: A follow-up analysis of a randomized clinical trial.PloS one · 2025Trial
- Trial
- Patient Risk Factors for Incidental Pathology After Uterovaginal Surgery for Apical Prolapse: Systematic Review and Global Expert Consensus Statements.International urogynecology journal · 2026Review
- A Retrospective Cohort Study of Bilateral Sacrospinous Ligament Fixation Over a Decade of Clinical Experience.International urogynecology journal · 2026Article
- Sacrospinous Hysteropexy Versus Vaginal Hysterectomy in Women with Uterine Prolapse: 10-year Follow-up of a Randomised Controlled Trial.International urogynecology journal · 2026Article
- Key Conditions for Successful Implementation of the Manchester Procedure as Primary Surgical Treatment for Mild to Moderate Uterine Prolapse: A Qualitative Study Among Dutch Gynecologists.International urogynecology journal · 2026Article
- Reliability of low-field upright MRI-based assessment of the polypropylene mesh after sacrocolporectopexy.Techniques in coloproctology · 2026Article
- Sacrospinous Ligament Fixation for Hysteropexy: Does Concomitant Anterior and Posterior Fixation Using a Posterior Approach Route Improve Surgical Outcomes?International urogynecology journal · 2026Article
- Observational
- Sacrospinous Ligament Fixation After Failed Sacrocolpopexy: A Case Series.Clinical case reports · 2025Article
- Surgical retreatment after native-tissue apical prolapse surgery with hysterectomy vs hysteropexy.American journal of obstetrics and gynecology · 2025Article
- The presacral-uterosacral hysteropexy - a novel native tissue repair for pelvic organ prolapse.Facts, views & vision in ObGyn · 2025Article
- Feasibility of the CT-Image-Guided Colpopexy: A Novel, Needle-Based Sacrospinous Ligament Fixation for Treatment of Vaginal Apical Prolapse.International urogynecology journal · 2025Article
- Sacrospinous Hysteropexy-Video Tutorial of Construction and Application of a Feasible and Inexpensive Teaching Model for Simulation.International urogynecology journal · 2025Article
- The External Validation of a Multivariable Prediction Model for Recurrent Pelvic Organ Prolapse After Native Tissue Repair: A Prospective Cohort Study.Journal of clinical medicine · 2025Article
- Investigating Causal Links Between Uterine Prolapse, Urinary Tract Infections, and Lower Urinary Tract Symptoms: A Two-Sample Mendelian Randomization Study.International journal of women's health · 2025Article
- Patient Impression of Improvement 1 year After Sacrospinous Hysteropexy Versus Vaginal Hysterectomy in Women with Pelvic Organ Prolapse Stage 2 or Higher.International urogynecology journal · 2024Article
- Nationwide assessment of practice variability in the utilization of hysteropexy at laparoscopic apical suspension for uterine prolapse.AJOG global reports · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the effectiveness and success of uterus preserving sacrospinous hysteropexy as an alternative to vaginal hysterectomy with uterosacral ligament suspension in the surgical treatment of uterine prolapse five years after surgery.
designObservational follow-up of SAVE U (sacrospinous fixation versus vaginal hysterectomy in treatment of uterine prolapse ≥2) randomised controlled trial.
settingFour non-university teaching hospitals, the Netherlands.
participants204 of 208 healthy women in the initial trial (2009-12) with uterine prolapse stage 2 or higher requiring surgery and no history of pelvic floor surgery who had been randomised to sacrospinous hysteropexy or vaginal hysterectomy with uterosacral ligament suspension. The women were followed annually for five years after surgery. This extended trial reports the results at five years.
main outcome measuresPrespecified primary outcome evaluated at five year follow-up was recurrent prolapse of the uterus or vaginal vault (apical compartment) stage 2 or higher evaluated by pelvic organ prolapse quantification system in combination with bothersome bulge symptoms or repeat surgery for recurrent apical prolapse. Secondary outcomes were overall anatomical failure (recurrent prolapse stage 2 or higher in apical, anterior, or posterior compartment), composite outcome of success (defined as no prolapse beyond the hymen, no bothersome bulge symptoms, and no repeat surgery or pessary use for recurrent prolapse), functional outcome, quality of life, repeat surgery, and sexual functioning.
resultsAt five years, surgical failure of the apical compartment with bothersome bulge symptoms or repeat surgery occurred in one woman (1%) after sacrospinous hysteropexy compared with eight women (7.8%) after vaginal hysterectomy with uterosacral ligament suspension (difference-6.7%, 95% confidence interval -12.8% to-0.7%). A statistically significant difference was found in composite outcome of success between sacrospinous hysteropexy and vaginal hysterectomy (89/102 (87%)
conclusionsAt five year follow-up significantly less anatomical recurrences of the apical compartment with bothersome bulge symptoms or repeat surgery were found after sacrospinous hysteropexy compared with vaginal hysterectomy with uterosacral ligament suspension. After hysteropexy a higher proportion of women had a composite outcome of success. Time-to-event analysis showed no differences in outcomes between the procedures.
trial registrationtrialregister.nl NTR1866.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.