Objective To explore the changes in quality of life before and after laparoscopic colposacropexy in elderly patients with uterine prolapse and to evaluate the influencing factors of quality of life. Methods Using a simple random sampling method, a questionnaire survey was conducted on 136 elderly patients with uterine prolapse, who underwent laparoscopic colposacropexy in Shanghai Ninth People′s Hospital Affiliated to Shanghai Jiaotong University from January 2021 to June 2023. Before surgery, and at 3 months and 6 months after surgery, pelvic floor distress inventory-short form 20 (PFDI-20) was used to evaluate the symptom changes of the patients, and pelvic floor impact questionnaire-short form 7 (PFIQ-7) was used to evaluate the changes in their quality of life. Pelvic organ prolapse quantification (POP-Q) was performed to evaluate the degree of uterine prolapse. Totally, 128 patients completed three surveys and the questionnaires were valid. Based on the PFIQ-7 score≤19.04 points at 6 months after surgery as the standard of good quality of life, they were divided into a good quality of life group (n=66) and a poor quality of life group (n=62). SPSS 24.0 was used for data analysis. According to the data type, one-way analysis of variance or Chi-square test was performed for between-group comparison. Multivariate logistic regression model was employed to analyze the influencing factors of poor quality of life in the elderly patients with uterine prolapse at 6 months after surgery. ResultsNo recurrence was found in the 128 elderly patients with uterine prolapse within 6 months after surgery. The PFDI-20 score and PFIQ-7 scores after surgery were significantly lower than those before surgery, and the scores at 6 months after surgery were lower than those at 3 months after surgery. The postoperative POP-Q measurements at Ba, C and Bp points were improved compared with those before surgery, and the differences were statistically significant (P<0.05). The differences in body mass index (BMI), parity, chronic constipation rate, degree of uterine prolapse, and incidence rates of postoperative complications were statistically significant between good quality of life group and poor quality of life group (P<0.05). Logistic regression analysis showed that BMI ≥ 27.0 kg/m² (OR=4.284,95%CI 2.706-6.784; P<0.05), parity≥ 3 times (OR=3.397,95%CI 1.786-6.483; P<0.05), chronic constipation (OR=2.550,95%CI 1.159-5.610; P<0.05), uterine prolapse Ⅳ degree (OR=3.307,95%CI 1.772-6.171; P<0.05), and postoperative complications (OR=2.492,95%CI 1.132-5.484; P<0.05) were risk factors of poor quality of life in the elderly patients with uterine prolapse at 6 months after surgery. Conclusion The quality of life after laparoscopic colposacropexy in the elderly patients with uterine prolapse increases with the extention of postoperative time, but obesity, multiparity, chronic constipation, severe uterine prolapse, and postoperative complications are important factors leading to poor postoperative quality of life. Clinically, it is necessary to take corresponding prevention and control measures for the above factors.