Between 27 November 2009 and 12 March 2012 , 208 women were randomly assigned to sacrospinous hysteropexy ( n=103 ) or to vaginal hysterectomy ( n=105 ) . The figure shows the flow of women through the study . Baseline characteristics were similar between the groups ( table 1 ) and pelvic measurements and characteristics did not differ at baseline ( table 2 ) . Table 3 presents the results on the primary outcome and the additional definitions of surgical failure . Sacrospinous hysteropexy was non - inferior to vaginal hysterectomy for anatomical recurrence of the apical compartment with bothersome bulge symptoms or repeat surgery for recurrent apical prolapse : sacrospinous hysteropexy 0 % ( n=0 ) versus vaginal hysterectomy 4.0 % ( n=4 ) , difference −3.9 % ( 95 % confidence interval −8.6 % to 0.7 % ) for the intention to treat - last observation carried forward approach . Non - inferiority of sacrospinous hysteropexy was also shown in the intention to treat analysis with conservative imputation and the per protocol analysis . The original primary outcome variable of overall anatomical failure occurred in 50 % of the women after sacrospinous hysteropexy compared with 44 % after vaginal hysterectomy ( 95 % confidence interval for difference −7.4 % to 20.1 % ) . No notable differences were found for anatomical recurrences in the different compartments , except for the posterior vaginal wall : sacrospinous hysteropexy 4 % versus vaginal hysterectomy 14 % ( 95 % confidence interval for difference −18.2 % to −1.8 % ) . Table 4 shows the intraoperative and postoperative details of the women , including the secondary outcomes of complication rate and length of hospital stay . Five serious adverse events were reported during hospital stay : two after vaginal hysterectomy and three after sacrospinous hysteropexy . One woman developed paralytic ileus after vaginal hysterectomy . She had also experienced this problem after orthopaedic surgery . She aspirated gastric contents eight days after surgery , developed aspiration pneumonia , and died because of multi - organ failure . The other serious adverse events were atrial fibrillation , which required cardioversion ( vaginal hysterectomy ) ; stroke two days after surgery , but with full recovery and no loss of function ( sacrospinous hysteropexy ) ; postoperative pneumonia ( sacrospinous hysteropexy ) ; and anaphylactic reaction to prophylactic antibiotics before the surgical procedure ( sacrospinous hysteropexy ) ; in this last woman the surgical procedure was postponed for several months , without any problems . None of the serious adverse events were judged to be related to the type of surgery . Tables 5 and 6 provide details on the other secondary outcomes . Functional outcome and quality of life did not differ significantly between the groups ( table 5 ) . Postoperative recovery was similar after both interventions , with comparable recovery index-10 scores at 1 , 2 , 4 , and 6 weeks after surgery ( table 6 ) . Among the patients who completed the pelvic organ prolapse / urinary incontinence sexual questionnaire before and after surgery , there was significant improvement in scores in both surgical groups ( P<0.002 each ) but no significant difference in total scores between both interventions ( table 6 ) . Flow of women through study . * intention to treat : two patients allocated to vaginal hysterectomy ( vH ) received sacrospinous hysteropexy ( sH ) and were analysed in the vH group . Data at six and 12 month follow up were missing in one patient after sH and six patients after vH ; one patient after vH had recurrent apical prolapse but pelvic organ prolapse quantification ( POP - Q ) score was missing , this patient was included in the intention to treat - last observation carried forward analysis . †Missed data imputed as failure . ‡Per protocol analysis : two patients did not receive intended treatment . excluded per protocol analysis : lost for follow - up at 12 months ( n=8 ) , missing or incomplete POP - Q score ( n=5 ) , and major protocol deviations ( n=9 ) ; two patients met two criteria to be excluded from per protocol analysis Pain scores on the visual analogue scale did not differ notably between both interventions , except for day 14 in favour of hysterectomy . In eight out of nine women who experienced buttock pain , a typically reported problem after sacrospinous hysteropexy , the pain resolved ( visual analogue scale score < 2 ) spontaneously within the first six weeks . One woman underwent suture cutting and vaginal hysterectomy after four months because of persistent pain localised at the place of the sacrospinous hysteropexy sutures . After this procedure she was free of symptoms .