Safety and efficacy of ischial spine fascia and sacrospinous ligament fixation for symptomatic stage 2 and 3 apical prolapse

Abstract

To compare safety, efficacy, and impact on quality of life (QoL) between ischial spine fascia fixation (ISFF) and sacrospinous ligament fixation (SSLF) for stage 2-3 pelvic organ prolapse (POP). A prospective cohort study among women with POP attending a national referral university hospital in Beijing, China, between May 2007 and May 2015. Women underwent either ISFF or SSLF. Primary end point was objective success rates at 3months after surgery. Exploratory outcomes included perioperative parameters, complications, subjective satisfaction rates and QoL at 1year. There was no difference in baseline characteristics between the groups (all P>0.05). After ISFF and SSLF, the objective success rate at 3months was 100% and 98.1% (P>0.99), the recurrence rate at 1year was 5.3% and 8.3% (P=0.266), and the subjective satisfaction rate at 1year was 97.8% and 97.9%, respectively. Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 scores improved significantly after ISFF. De novo urinary incontinence occurred for 5.3% and 6.3% of women, respectively, and de novo dyspareunia for approximately 14% of women in both groups. ISFF was found to be a safe and effective alternative to SSLF for women with symptomatic stage 2 and 3 POP.