Effect of body mass index on surgical outcomes in patients undergoing laparoscopic sacrohysteropexy and sacrocolpopexy

Introduction: Laparoscopic promontofixation is often considered the preferred approach for the treatment of significant apical pelvic organ prolapse (POP). Obesity is an established risk factor for pelvic organ prolapse (POP), and obese patients may constitute a substantial portion of those seeking care for uterovaginal prolapse. Our aim was to evaluate the impact of body mass index on perioperative complications and long-term outcomes of this procedure. Methods: This is a single center retrospective cohort study. All patients who underwent laparoscopic sacrohysteropexy/sacrocolpopexy, between July 2011 and December 2021 were evaluated. The study population was divided into three groups, according to Body mass index (BMI) at time of surgery. Results: Altogether 246 patients were included: 145 in group 1 (mean BMI 21.9 ± 2), 88 patients in group 2 (mean BMI 27.1 ± 1), and 13 patients in group 3 (mean BMI 33.0 ± 3). LSH was more frequent than LSC in all groups. The overall perioperative complications rate was 6.3 %. There were no differences in operative details and rates of perioperative complications between the groups. During follow-up period, 30 patients (12.2 %) presented with prolapse recurrence (objective and/or subjective). The rates of prolapse recurrence, as well as long-term complications, were similar between the groups. Similarly, the groups did not differ in postoperative functional results except for postoperative constipation (group 1––14.5 %, group 2––23.8 %, group 3––25 %, p = 0.001). Conclusion: Laparoscopic sacrohysteropexy/sacrocolpopexy is associated with low rates of perioperative and long- term complications. We did not find a difference in rates of complications and/ or long-term outcomes, between different weights groups.