***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Introduction and hypothesisIn a retrospective study , the sacrospinous hysteropexy was associated with a shorter recovery time compared to a vaginal hysterectomy with no differences in anatomical outcomes . No r and omized trials are performed . Methods Sixty-six women with stage 2–4 uterine descent were r and omized for vaginal hysterectomy(31 ) or sacrospinous hysteropexy(35 ) . Recovery time , anatomical outcomes , functional outcomes , and quality of life were measured . Results Length of time to return to work was shorter after a sacrospinous hysteropexy ( 43 versus 66 days , p = 0.02 ) . The difference in risk for recurrent prolapse stage 2 or more of the apical compartment at 1-year follow-up was 17 % ( 95 % confidence interval , 2 to 30 ) in favor of the vaginal hysterectomy . No differences in quality of life and urogenital symptoms were found . Conclusions The sacrospinous hysteropexy for uterine descent is associated with an earlier recovery time , more recurrent apical prolapses but no differences in functional outcomes , and quality of life Introduction and hypothesisHysterectomy is often part of pelvic organ prolapse repair . However , this may offer no benefit when compared to uterine preservation . We aim ed to prospect ively evaluate a minimally invasive bilateral sacrospinous hysteropexy using polypropylene mesh . We hypothesized that anatomic success and patient satisfaction can be achieved with this technique . Methods Women with uterovaginal prolapse desiring surgery who had completed childbearing were enrolled . Preoperative assessment included st and ardized prolapse examination and vali date d symptom and pain scale question naires . Women with prior pelvic organ prolapse repair or any contraindication to uterine preservation were excluded . Data including demographic , operative and postoperative information was collected on patients for 1 year following surgery . Continuous variables are summarized as means ( st and ard deviation ) and categorical variables are summarized as frequencies and percentages . A mixed-effects model was used to evaluate the changes in question naire scores and outcomes at 6 months and 12 months after surgery with r and om effects accounting for the center effect with adjustment for age . Results The study group comprised 99 women from three female pelvic medicine and reconstructive surgery ( urogynecology ) centers . The average age of the participants was 67.0 years ( 11.32 years ) , BMI 26.04 kg/m2 ( 3.56 kg/m2 ) , and the majority were multiparous ( 98.9 % ) and menopausal ( 90.9 % ) .  Overall success at 12 months , as measured by composite outcome was 97.7 % ( with the Ba point as the anatomic l and mark ) and 96.6 % ( with the C point as the anatomic l and mark ) . The overall exposure rate was 6.52 % and reoperation rate was 7.53 % . All subjective question naire scores and anatomic outcomes had improved at 12 months . Conclusions Sacrospinous hysteropexy using a minimally invasive polypropylene mesh kit is an effective and safe technique for addressing uterovaginal prolapse as an alternative to hysterectomy at the time of pelvic reconstructive surgery Background Pelvic organ prolapse is a common health problem , affecting up to 40 % of parous women over 50 years old , with significant negative influence on quality of life .  Vaginal hysterectomy is currently the leading treatment method for patients with symptomatic uterine prolapse . Several studies have shown that sacrospinous fixation in case of uterine prolapse is a safe and effective alternative to vaginal hysterectomy . However , no large r and omized trials with long-term follow-up have been performed to compare efficacy and quality of life between both techniques . The SAVE U trial is design ed to compare sacrospinous fixation with vaginal hysterectomy in the treatment of uterine prolapse stage 2 or higher in terms of prolapse recurrence , quality of life , complications , hospital stay , post-operative recovery and sexual functioning . Methods / design The SAVE U trial is a r and omized controlled multi-center non-inferiority trial . The study compares sacrospinous fixation with vaginal hysterectomy in women with uterine prolapse stage 2 or higher . The primary outcome measure is recurrence of uterine prolapse defined as : uterine descent stage 2 or more assessed by pelvic organ prolapse quantification examination and prolapse complaints and /or redo surgery at 12 months follow-up . Secondary outcomes are subjective improvement in quality of life measured by generic ( Short Form 36 and Euroqol 5D ) and disease-specific ( Urogenital Distress Inventory , Defecatory Distress Inventory and Incontinence Impact Question naire ) quality of life instruments , complications following surgery , hospital stay , post-operative recovery and sexual functioning ( Pelvic Organ Prolapse/Urinary Incontinence Sexual Question naire ) . Analysis will be performed according to the intention to treat principle . Based on comparable recurrence rates of 3 % and considering an upper-limit of 7 % to be non-inferior ( beta 0.2 and one sided alpha 0.025 ) , 104 patients are needed per group . Discussion The SAVE U trial is a r and omized multicenter trial that will provide evidence whether the efficacy of sacrospinous fixation is similar to vaginal hysterectomy in women with uterine prolapse stage 2 or higher . Trial registration Netherl and s Trial Register ( NTR ) : It has been reported that , by the age of 80 , the risk of women to undergo surgery for the treatment of pelvic organ prolapse ( POP ) exceeds 10 % , a percentage expected to increase with the rise in life expectancy . The vaginal approach for POP reconstructive operations is associated with fewer complications and results in a shorter rehabilitation period than the abdominal route , whereas hysterectomy is widely performed concomitantly whenever the uterus is significantly prolapsed . However , there is no clear evidence supporting the role of hysterectomy in improving surgery outcome . We present our experience with a new minimally invasive procedure — the posterior intravaginal slingplasty ( PIVS ) for correction of advanced uterine prolapse — at the same time , comparing additive vaginal hysterectomy to uterine preservation , to evaluate the therapeutic significance of hysterectomy when vaginal apical prolapse is reconstructed with PIVS . Seventy-nine women presenting with moderate to severe uterine prolapse were enrolled into the current PIVS study . Vaginal hysterectomy was concomitantly performed upon patient ’s request ( 44 patients ) , whereas those wishing to preserve their uterus underwent reconstructive surgery only ( 35 patients ) . No intraoperative or postoperative major complications were recorded during an average follow-up of 29.8 months : One patient ( 1.3 % ) presented with surgical failure , whereas 71 ( 89.9 % ) of the operated patients reported satisfaction with the therapeutic results . Bladder overactivity symptoms declined from three thirds of the patients preoperatively to below 10 % postoperatively . Ten ( 12.7 % ) patients had vaginal tape protrusion ;  all underwent  segmental tape resection  at the out-patient clinic . Because the PIVS procedure does not require either laparotomy or deep transvaginal dissection , as previously required for operative intervention , the hospitalization period was relatively short : 4.2 days for the hysterectomy group and 1.5 for the non-hysterectomy group . Other statistically significant differences between the hysterectomy and non-hysterectomy groups were the average ages ( 63.5 vs 51.0 years , respectively ) and concomitant surgery ( 87 % vs 69 % , respectively , the higher percentage due to additive amputation of elongated uterine cervices ) . No other significant differences were recorded . The current results support the previously reported efficacy , safety , and simplicity of the PIVS procedure as well as the legitimacy of uterine preservation . Moreover , unstable bladder symptoms were found to be improved after this operation . However , long-term data are required to be able to draw solid conclusions concerning the superiority of the discussed operation OBJECTIVE This study aim ed to evaluate the efficacy of colposacropexy with uterine preservation as therapy for uterovaginal prolapse . Surgical techniques , efficacy and overall results are described . METHODS In this prospect i ve , controlled study , 34 of the 72 consecutive patients with symptomatic uterovaginal prolapse were treated with  colposacropexy with uterus conservation ( hysterocolposacropexy , HSP ) and the other 38 with hysterectomy followed by sacropexy ( CSP ) . Anchorage was achieved with two rectangular meshes in CSP and with one posterior rectangular and one anterior Y-shaped mesh in HSP . Check-ups were scheduled at 3 , 6 and 12 months and then yearly . Pre-operative patient characteristics , operative and post-operative events and follow-up results were recorded . Mean follow-up was 51 months ( range 12 - 115 ) . RESULTS No significant differences emerged in demographic and clinical characteristics between the HSP and CSP groups . Mean operating times , intra-operative blood loss and hospital stay were significantly less after HSP ( p<0.001 ) . At follow-up success rates were similar in the two groups in terms of uterine and upper vaginal support ( 100 % ) . Recurrent low- grade cystoceles developed in 1/38 ( 2.6 % ) in the CSP group and in 5/34 ( 14.7 % ) in the HSP group ( p = NS ) , recurrent low- grade rectocele developed in 6/38 ( 15.8 % ) and in 3/34 ( 8.8 % ) patients respectively ( p = NS ) . No patient required surgery for recurrent vault or uterus prolapse . Urodynamic results showed that pressure/flow parameters improved significantly ( p<0.001 ) in both groups . Thirty-one of the 34 patients ( 91 % ) in the HSP group and 33/38 ( 86.8 % ) in the CSP group were satisfied and would repeat surgery again . CONCLUSIONS Colposacropexy provides a secure anchorage , restoring an anatomical vaginal axis and a good vaginal length . HSP can be safely offered to women who request uterine preservation . Whether the uterus was preserved or not , patients had similar results in terms of prolapse resolution , urodynamic outcomes , improvements in voiding and sexual dysfunctions . HSP has shorter operating times and less blood loss OBJECTIVES To compare surgical morbidity and time , as well as anatomical outcomes between vaginal histerectomy and uterine preservation in the treatment of uterine prolapse using a mesh kit ( Nazca ) . METHODS R and omized controled trial with 31 women with uterine prolapse POP-Q stage 3 or 4 pelvic organ prolapse who underwent vaginal surgery using tipe I polypropilene mesh ( Nazca ) . They were r and omized in two groups : group HV : hysterectomy and pelvic reconstruction floor with mesh ( n=15 ) ; group HP : hysteropexy and pelvic reconstruction floor with mesh ( n=16 ) . Race , miccional urgency , intestinal constipation , sacral pain were assessed as well as the amount of bleeding and time of operation . RESULTS Median follow-up was nine months on both groups . No difference was observed on complication rates and functional outcomes . Operation time was 120 minutes on group HV , versus 58.9 minutes on group HP ( X(2 ) = 17.613 * , p < 0.001 ) and intraoperative blood loss was 120 mL on group HV versus 20 mL on group HP ( X(2 ) = 19.425 * ; p < 0.001 ) . There was no differences in relationship to anatomical cure rates . Objective success rate was 86.67 % to group HV and 75 % to group HP ( p=0,667 ) at nine months of follow-up . The anatomical results were similar between the two groups . CONCLUSION The anatomic results between histeropexy and hysterectomy were similar . However , surgical time and blood loss were greater in group with histerectomies . The erosion rate were also similar . Vaginal surgery using mesh is an effective procedure for pelvic organ prolapse Introduction and hypothesisWe have previously reported on laparoscopic hysteropexy for uterine prolapse . We now report a pilot r and omized study comparing laparoscopic hysteropexy ( LH ) with vaginal hysterectomy ( VH ) for the surgical management of uterine prolapse . Methods Women with symptomatic uterine prolapse requiring surgery for uterine prolapse were recruited . The data were analyzed for those who had completed a 1-year follow-up . As this is a pilot r and omized study , no power calculation was available . The main primary outcome measure was repeat apical prolapse . Secondary outcomes included operation data , complications , recovery time , functional and QoL outcomes , and anatomical outcomes . Wilcoxon signed  rank and Mann – Whitney tests compared pre-operative with post-operative data and the difference between the two groups respectively . Results One hundred and thirty-two women were recruited . Of these , 101 were r and omized . Eighty percent of the 31 women who dropped out preferred LH . One-year follow-up data were analyzed for 37 women in the LH and 35 women in the VH group . Time before return to normal activity was significantly shorter , estimated blood loss was significantly less , pain score 24 h post-operatively was significantly lower , and hospital 
    Output:
    
Conclusions Overall , the rate of recurrence of uterine prolapse was not lower but the rate of reoperation for prolapse was lower following hysterectomy , while operative time was shorter and blood loss was less with hysteropreservation .