Mesh-sacropexy in women with apical pelvic organ prolapse – results of a single-centre prospective cohort study

Pelvic organ prolapse (POP) affects nearly half of women, highly influencing quality of life. When conservative treatment fails, surgical repair is indicated, with sacropexy representing the current gold standard for apical POP (aPOP) repair. Prospective single-centre cohort study including patients (pts) with aPOP and indication for surgery using polyvinylidene fluoride (PVDF) mesh (DynaMesh®) for sacrocervicopexy, sacrocolpopexy, or sacrohysteropexy at the University Hospital Bonn. Clinical data, peri- and postoperative outcomes, and follow-ups at 8 weeks (FU2), 6 months (FU3), and 12 months (FU4) postoperatively were analysed. The primary endpoint was the recurrence at FU4, defined as aPOP-Q ≥ grade II. Secondary endpoints included quality of life using the German Pelvic Floor Questionnaire (GPFQ), International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI-SF), and a study-specific questionnaire. A total of 90 women (median age 60 years [range 34–83], median body mass index 24.5 kg/m² [range 19.5–40.3]) underwent POP surgery between 2022 and 2024. Most procedures were robotic-assisted sacrocervicopexies (77.8%). Perioperative complications occurred in 4.4% (intraoperative) and 6.7% (postoperative) of cases. Median hospital stay was 5 days (range 3–9). Until FU4, no apical recurrences were observed; cumulatively, de-novo mesh erosion occurred in 4.4% of pts, with 2.2% requiring surgical revision. De-novo urinary incontinence was rare (5.5%). Subjective outcomes included scores of GPFQ and ICIQ-UI-SF, which improved significantly at all follow-up visits compared to preoperatively. 93% of pts were satisfied with the operation, 94% would choose it again, and 95% of pts would recommend this operation to a friend. Mesh-assisted sacropexy was associated with high apical success rates and favourable patient-reported outcomes at 12 months. Complication and reoperation rates were low within the observed follow-up period. However, longer-term data are required to fully evaluate durability and safety. Registration number: DRKS00038856. Registration date: 08th January 2026, registered retrospectively