Safety and efficiency of modified sacrospinous ligament fixation for apical prolapse: Long-term studies and outcomes.

Abstract

To explore the safety and efficiency of modified sacrospinous ligament fixation (MSSF) for apical prolapse. A retrospective cohort study. Patients diagnosed with apical prolapse from 2014 to 2019 were recruited and divided into three groups: sacrospinous ligament fixation (SSF), MSSF, and laparoscopic sacral hysteropexy (LSH). All surgical characteristics were obtained and information concerning complications was collected and compared among these three groups. A total of 710 patients were included: 108 in the SSF group, 260 in the LSH group, and 342 in the MSSF group. The MSSF and SSF groups took less surgical time (P<0.001) and had shorter hospital stays (P<0.001). All three methods can significantly change prolapses to point C on the POP quantification score (P<0.001). Prevalence of vaginal and pelvic pain after surgery was higher in the SSF group (8/108; 7.41%) (P=0.028), and urinary incontinence was higher in the LSH group (22/260; 8.46%) (P=0.010). In the LSH group more patients experienced constipation and dyschezia after surgery (prevalence 18/260; 6.92%; P=0.048). Recurrence of pelvic organ prolapse in the MSSF group (15/324; 4.39%) and LSH group (12/260; 4.62%) was much lower than in the SSF group (16/108; 14.81%) (P<0.001). The efficacy of MSSF is commendable with low recurrence of POP and few complications in long-term follow up.