To compare laparoscopic lateral suspension (LLS) and transvaginal natural orifice transluminal endoscopic surgery lateral suspension (vNOTES-LS) in the surgical treatment of pelvic organ prolapse (POP), focusing on anatomical outcomes and complication rates.
Single-center retrospective cohort study.
A total of 111 women with stage ≥ 2 apical POP who underwent LLS (n = 63) or vNOTES-LS (n = 48) between August 2020 and March 2024. Subgroup analyses were performed based on uterine preservation status.
The overall surgical success rate was 82.5% in the LLS group and 95.8% in the vNOTES-LS group. vNOTES-LS was associated with significantly greater improvement in POP-Q points (Aa, Ap, Ba,Bp, C; p < 0.05 for all). Reoperation rates were significantly lower in the vNOTES uterine-preserving subgroup compared to the corresponding LLS subgroup (4.2% vs. 17.5%, p = 0.035). Estimated blood loss was higher in the vNOTES group (p = 0.0001). Intraoperative and postoperative complication rates were comparable between the groups (p > 0.05 for all). All late mesh removals due to pelvic pain occurred in the LLS group.
Both LLS and vNOTES-LS are effective and safe techniques for POP repair. vNOTES-LS appears to provide superior anatomical outcomes and lower reoperation rates, particularly uterine-preserving cases, supporting its broader adoption in minimally invasive pelvic reconstructive surgery.
European journal of obstetrics, gynecology, and reproductive biology. 2026 Mar 18 [Epub ahead of print]
Fatma Ketenci Gencer, Suleyman Salman, Serkan Kumbasar, Havva Betul Bacak, Enes Serhat Coskun, Sema Rumeysa Bilici, Bariscan Aldanmaz, Batuhan Bulut, Ecenur Celikoglu, Yagmur Aciyiyen, Hayat Terkan, Fatma Tunccag, Oguzhan Karakoc, Tuğba Salman, Koray Gorkem Sacıntı
Department of Obstetrics and Gynecology, Gaziosmanpasa Training and Research Hospital, University Of Health Sciences, Istanbul, Turkey. Electronic address: ., Department of Obstetrics and Gynecology, Gaziosmanpasa Training and Research Hospital, University Of Health Sciences, Istanbul, Turkey., Demirtepe Life Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey., Professor Cemil Tascioglu City Hospital, Istanbul, Turkey., Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.