Anterior colporrhaphy (AC) is commonly used for anterior vaginal wall prolapse, but suffers high recurrence rates. This randomized trial assessed whether adding transobturator lateral suspension (TOLS) to AC decreases objective recurrence without compromising patient outcomes. In a cohort of 44 women (POP-Q ≥ 2), AC alone was compared to AC+TOLS over a 1-year follow-up. Results showed significantly lower objective recurrence with the added suspension.

Conducted prospectively at University Medical Centre Maribor (Slovenia), this single-surgeon RCT randomized women with symptomatic anterior vaginal prolapse (POP-Q stage ≥ 2) to receive either standard AC or AC plus bilateral TOLS via non-absorbable suture across the obturator foramen. Primary outcome was objective anatomical recurrence (POP-Q ≥ 2) at 1 year. Secondary outcomes included subjective recurrence, satisfaction (Likert), operative time, postoperative and pelvic sidewall pain, and validated QOL instruments (UIQ-7, CRAIQ-7, POPIQ-7, PFIQ, POPDI-6, UDI-6, PFDI, PISQ).

Inclusion Criteria:

• Adult women with symptomatic anterior vaginal wall prolapse (POP-Q stage ≥ 2)
• Eligible for native tissue repair
• Provided written informed consent

Exclusion Criteria:

• Previous anterior vaginal wall prolapse repair
• Predominant apical or posterior compartment defect

De-identified individual participant data (IPD) that underlie the results reported in this article, including baseline characteristics, intraoperative details, and outcome measures (objective recurrence, subjective recurrence, patient satisfaction, operative time, postoperative pain scores, and quality-of-life questionnaire scores), will be available to researchers upon reasonable request. Data will be shared beginning 6 months after publication of the main results and ending 5 years after article publication.

Start immediately, until 2027

Access will be granted to investigators who provide a methodologically sound proposal, subject to approval by the corresponding author and the Institutional Ethics Committee. Data will be shared via a secure institutional repository following signing of a data access agreement.