Prospective multicentre registry study on sacropexy using the semitendinosus tendon for apical prolapse repair: an interim analysis.

Abstract

<h4>Study objective</h4>Pelvic organ prolapse (POP) affects more than 40% of parous women. This registry study evaluates clinical and patient-reported outcomes of minimally invasive sacropexy using the autologous semitendinosus tendon for apical prolapse repair.<h4>Design</h4>Prospective multicentre registry interim analysis.<h4>Setting</h4>Six centres for minimally invasive pelvic floor surgery in Germany, Austria, and Switzerland.<h4>Participants</h4>Patients with symptomatic apical POP (POP-Q ≥1) undergoing laparoscopic or robotic-assisted sacropexy between March 2023 and September 2025 (n=514).<h4>Interventions</h4>Sacropexy was performed using an autologous semitendinosus tendon graft.<h4>Measurements</h4>Outcomes were assessed at discharge, 3 months (FU3), and 12 months (FU12) using POP-Q staging and the validated German Pelvic Floor Questionnaire (GPFQ). Anatomical correction (POP-Q points Ba, Bp, C), complication rates, reoperation for POP, and patient-reported pelvic floor symptoms (GPFQ).<h4>Main results</h4>Median age was 62 years and median BMI 24.2 kg/m²; 8.9% had previous POP surgery. Mean tendon harvesting time was 7 minutes and mean hospital stay 4 days. Intraoperative complications occurred in 3.5% and postoperative complications in 5.3%. POP-Q points Ba, Bp, and C improved significantly at all follow-ups (all p<0.05). Reoperation for POP occurred in 3.9% by FU12 without clinically relevant apical recurrence. All GPFQ domains improved significantly (total score 12.3 preoperatively vs. 4.5 at FU3 and 5.4 at FU12; p<0.001). Stress urinary incontinence symptoms decreased significantly.<h4>Conclusions</h4>Autologous semitendinosus sacropexy is a safe minimally invasive alternative to mesh-based repair, providing excellent anatomical outcomes and significant quality-of-life improvement at mid-term follow-up.