Table. Some of the recommendations that have been updated in the S3 guideline on pelvic organ prolapse, listed here for illustrative purposes with selected new randomized, controlled trials.

n	Comparison	Study design	Primary endpoint	Results [95% CI]	Adverse events
Study: van Ijsselmuiden et al. (2020) (e31)
126	laparoscopic sacrohysteropexy vs. vaginal sacrospinal hysteropexy	anatomical apical recurrences	apical recurrences in 1/54 (2%) vs. 2/58 (3%)		the two operations have the same recurrence rates
Study: Lucot et al. (2018) (e32)
262	laparoscopic sacrocolpopexy vs. transvaginal mesh for cystocele	reoperations	n = 6/129 (5%) vs. n = 14/128 (11%) reoperations for complications 1 (1%) vs. 11 (9%)*	continence operations: 4/129 (3%) vs. 1/128 (0.8%) de novo dyspareunia: 10/71 (14 %) vs. 18/61 (30 %)*	sacrocolpopexy and vaginal mesh inserts are both effective; after sacrocolpopexy there is less dyspareunia
Study: Lucot et al. (2022) (e33)
209	laparoscopic sacrocolpopexy vs. transvaginal mesh for cystocele	recurrences and complications. 4-year follow-up	vaginal apex (POPQ C) in mm– 51.7 ± 27.1 vs. – 59.7 ± 1.7 complications 2% [0; 4.7] vs. 8.7% [3.4; 13.7]: H R 4.6 [1.007; 21]*	de novo/exacerbated dyspareunia 3%, 2/65 vs. 10%, 6/61	sacrocolpopexy and vaginal mesh inserts are both effective; after sacrocolpopexy there is less dyspareunia
Study: Bataller et al. (2019) (e34)
120	laparoscopic sacrocolpopexy vs. vaginal anterior mesh	apical recurrences anterior recurrences	57/58 (98%) vs. 55/58 (95%) 34/58 (58%) vs. 32/58 (55%)	de novo dyspareunia 3 (7%) vs. 7 (19%)	sacrocolpopexy and vaginal mesh inserts are both effective; after sacrocolpopexy there is less dyspareunia
Study: Coolen et al. (2017) (e35)
74	laparoscopic vs. open sacrocolpopexy	PGI(Patient‘s Global Impression) score	71% (22/31) vs. 74% (20/27)		laparoscopy is just as good as open surgery and is to be preferred
Study: Noe et al. (2015) (e36)
83	pectopexy with vaginal and laparoscopic fascial reconstruction, vs. sacrocolpopexy	anatomical recurrences	1/42 (2%) vs. 4/41 (10%)	sacropexy 5 de novo defecation disturbance vs. 0 for pectopexy	pectopexy is a good option for apical prolapse
Study: Schulten et al. (2019) (e37)
208	sacrospinal hysteropexy vs. vaginal hysterectomy with uterosacral ligament fixation	anatomical recurrences/symptoms (combined endpoint) follow-up: 60 months	anatomical recurrences: 46/102 (45%) vs. 51/102 (50%) difference: –4.8 [-18.5; 8.9]	stress incontinence:2 vs. 7	vaginal surgery with and without hysterectomy is equivalent
Study: Jelofsek (2018) (e38)
374	uterosacral ligament fixation vs. sacrospinal fixation 5-year follow-up	feeling of bulging;lowering of the apex by > 1/3 of the upper vagina, reoperation	68/133 (51%) vs. 80/134 (60%) (combined endpoint)		similar outcomes from both procedures
Study: Ahmed et al. (2020) (e39)
84	anterior repair with suburethral sling versus anterior 4-arm mesh insertion	stress incontinence and recurrent prolapse	6/42 (12%) vs. 3/43 (7%) 6/41 vs. 1/43		recurrent prolapse:both procedures comparable stress urinary incontinence: possibly anterior repair with suburethral sling

CI, confidence interval; HR, hazard ratio; POPQ, Pelvic Organ Prolapse Quantification; *statistically significant, p ≤ 0.05