Perioperative Complications in Abdominal Sacrocolpopexy, Sacrospinous Ligament Fixation and Prolift Procedures

Abstract Introduction and hypothesis Sacrocolpopexy and sacrospinous ligament fixation (SSLF) have been used for the restoration of apical support. Studies comparing sacrocolpopexy and SSLF have reported conflicting results. We aim to assess the current evidence regarding efficiency and the complications of sacrocolpopexy compared with SSLF. Methods We searched PubMed, Embase, and Cochrane Library and performed a systematic review meta-analysis to assess the two surgical approaches. Results 5Five randomized controlled trials, 8 retrospective studies, and 2 prospective studies including 4,120 cases were identified. Compared with abdominal sacrocolpopexy (ASC), SSLF was associated with a lower success rate (88.32% and 91.45%; OR 0.52; 95% CI 0.29–0.95; p = 0.03), higher recurrence (11.58% and 8.32%; OR 1.97; 95% CI 1.04–3.46; p = 0.04), and dyspareunia rate (14.36% and 4.67%; OR 3.10; 95% CI 1.28–7.50; p = 0.01). Patients in this group may benefit from shorter operative time (weighted mean difference −25.08 min; 95% CI −42.29 to −7.88; p = 0.004), lower hemorrhage rate (0.85% and 2.58%; OR 0.45; 95% CI 0.25–0.85; p = 0.009), wound infection rate (3.30% and 5.76%; OR 0.55; 95% CI 0.39–0.77; p = 0.0005), and fewer gastrointestinal complications (1.33% and 6.19%; OR 0.33; 95% CI 0.15–0.76; p = 0.009). Conclusion Both sacrocolpopexy and SSLF offer an efficient alternative to the restoration of apical support. When anatomical durability and sexual function is a priority, ASC may be the preferred option. When considering factors of mesh erosion, operative time, gastrointestinal complications, hemorrhage, and wound infections, SSLF may be the better option.

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Vaginal sacrospinous ligament fixation versus abdominal sacrocolpopexy for the treatment of vaginal cuff prolapse: A retrospective study

Annals of Medical Research ◽

10.5455/annalsmedres.2019.01.016 ◽

2019 ◽

pp. 1

Author(s):

Isil Koleli ◽

Ercan Yilmaz

Keyword(s):

Retrospective Study ◽

Sacrospinous Ligament ◽

Vaginal Cuff ◽

Sacrospinous Ligament Fixation ◽

Abdominal Sacrocolpopexy

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Laparoscopic uterosacral ligament suspension versus sacrospinous ligament fixation for apical prolapse: perioperative outcomes

Gynecological Surgery ◽

10.1186/s10397-021-01098-3 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Martina G. Gabra ◽

Veronica Winget ◽

Mohammad T. Torabi ◽

Ilana Addis ◽

Kenneth Hatch ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Perioperative Complications ◽

Pelvic Organ ◽

Uterosacral Ligament ◽

Perioperative Outcomes ◽

Complication Rates ◽

Uterosacral Ligament Suspension ◽

Confounding Factors ◽

Sacrospinous Ligament ◽

Sacrospinous Ligament Fixation

Abstract Background Pelvic organ prolapse can be repaired vaginally or laparoscopically. Studies comparing vaginal repair with sacrospinous ligament fixation (SSLF) or uterosacral ligament suspension (V-USLS) have found no difference in functional or adverse outcomes. Laparoscopic USLS (L-USLS) is becoming a popular treatment for pelvic organ prolapse because it has a low rate of ureteral compromise. To date, no studies have compared perioperative outcomes between L-USLS and SSLF. The objective of this study is to compare the rates of perioperative complications between these two methods. Methods This was a retrospective chart review of 243 consecutive patients who underwent L-USLS or SSLF at one institution between March 2017 and August 2019 for apical pelvic organ prolapse. Descriptive data was analyzed as appropriate with Student’s t tests and chi-square. Univariable logistic regression analysis was performed to assess predictors of perioperative complications. Results Preoperative Pelvic Organ Prolapse Quantification Stage (POP-Q) was similar between the two cohorts (p = 0.23). After adjusting for confounding factors, L-USLS was associated with a longer operative time (118 vs 142 min, p < 0.01) and shorter length of hospitalization (0.68 vs 1.06 days, p < 0.01). The estimated blood loss between the procedures was not statistically significant after adjusting for confounding factors. There was no difference in perioperative complication rates between L-USLS and SSLF (5% vs 7%, p = 0.55). No clinical risk factors were significantly associated with perioperative complications. Conclusion We did not find a difference in complications between L-USLS and SSLF.

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Comparison of transvaginal sacrospinous ligament fixation with abdominal sacrocolpopexy in treatment of post-hysterectomy vault prolapse-a prospective randomized study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20215099 ◽

2021 ◽

Vol 11 (1) ◽

pp. 177

Author(s):

Kamal Kumar Dash ◽

Anjan Dasgupta ◽

Abirbhab Pal ◽

Ayantika Chakraborty ◽

Barsarani Dash ◽

...

Keyword(s):

Operating Time ◽

Group Versus ◽

Vaginal Vault Prolapse ◽

Vaginal Vault ◽

Sacrospinous Ligament ◽

Vault Prolapse ◽

Sacrospinous Ligament Fixation ◽

Abdominal Sacrocolpopexy ◽

Significant Difference ◽

The Mean

Background: Vaginal vault prolapse is a common condition following abdominal or vaginal hysterectomy causing negative impact on women’s quality of life. The study compares the efficacy of abdominal and vaginal route surgery in correcting post-hysterectomy vault prolapse by postoperative assessment and at least twelve months follow up.Methods: A prospective comparative study among post-hysterectomy patients attending the GOPD of Midnapore Medical College diagnosed as vaginal vault prolapse at least stage2 between January 2013 to December 2019. The study population included 31 women divided into two groups-group A included 16 women underwent unilateral sacrospinous ligament fixation (SSF) and group B included 15 women underwent abdominal sacrocolpopexy (ASC).Results: There was no significant difference between the two groups in terms of mean age, mean weight, mean parity and BMI, hence both groups are comparable. The mean operating time was 117±19.68 min in ASC group and 83.25±11.28 min in SSF group (p<0.005); significant mean blood loss was reported in ASC group (373±97.79 ml in ASC group versus 193.125±98.97 ml in SSF group, p<0.005), more hospital stays in ASC group (p<0.005) and more post operative complications in ASC group than SSF group. At follow up, the mean vaginal length showed significantly longer for ASC group than that of SSF group (p<0.005).Conclusions: ASC and SSF, both techniques are effective in management of vault prolapse in hands of an expert though recovery time is much quicker in SSF group.

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Laparoscopic Uterosacral Ligament Suspension versus Sacrospinous Ligament Fixation for Apical Prolapse: Perioperative Outcomes

10.21203/rs.3.rs-208585/v1 ◽

2021 ◽

Author(s):

Martina Gabra ◽

Veronica Winget ◽

Mohammad T Torabi ◽

Ilana Addis ◽

Kenneth Hatch ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Perioperative Complications ◽

Pelvic Organ ◽

Uterosacral Ligament ◽

Perioperative Outcomes ◽

Complication Rates ◽

Uterosacral Ligament Suspension ◽

Confounding Factors ◽

Sacrospinous Ligament ◽

Sacrospinous Ligament Fixation

Abstract Background: Pelvic organ prolapse can be repaired vaginally or laparoscopically. Studies comparing vaginal repair with sacrospinous ligament fixation (SSLF) or uterosacral ligament suspension (V-USLS) have found no difference in functional or adverse outcomes. Laparoscopic USLS (L-USLS) is becoming a popular treatment for pelvic organ prolapse because it has a low rate of ureteral compromise. To date, no studies have compared perioperative outcomes between L-USLS and SSLF. The objective of this study is to compare the rates of perioperative complications (intraoperative and postoperative complications) between these two methods.Methods: This was a retrospective chart review of 243 consecutive patients who underwent L-USLS or SSLF at one institution between 3/2017 and 8/2019 for apical pelvic organ prolapse. Descriptive data was analyzed as appropriate with student t-tests and Chi Square. Univariable Logistic Regression analysis was performed to assess predictors of perioperative complications.Results: Preoperative Pelvic Organ Prolapse Quantification Stage (POP-Q) was similar between the two cohorts (p=0.23). After adjusting for confounding factors, L-USLS was associated with a longer operative time (118 vs 142 min, p <0.01) and shorter length of hospitalization (0.68 vs 1.06 days, p <0.01). The estimated blood loss between the procedures was not statistically significant after adjusting for confounding factors. There was no difference in perioperative complication rates between L-USLS and SSLF (5% vs 7%, p = 0.55). No clinical risk factors were significantly associated with perioperative complications.Conclusion: We did not find a difference in complications between L-USLS and SSLF.

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