Skip to main content
SpringerLink
Log in

Comparison of 2-year follow-up outcomes of laparoscopic lateral suspension and sacrospinous fixation in apical compartment prolapse: an observational study

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to compare the results of patients with laparoscopic lateral suspension (LLS) and sacrospinous fixation (SSF).

Methods

This prospective observational study included 52 patients who underwent LLS and 53 patients who underwent SSF due to pelvic organ prolapse. The pelvic organ prolapse’s anatomical cure and the frequency of recurrence have been recorded. Female Sexual Function Index, Pelvic Organ Prolapse Symptom Score, and complications were evaluated preoperatively and at the postoperative 24th month.

Results

In the LLS group, the subjective treatment rate was 88.4% and the anatomical cure rate for apical prolapse was 96.1%. In the SSF group, the subjective treatment rate was 83.0% and the anatomical cure rate for apical prolapse was 90.5%. There was a significant difference between the groups regarding Clavien-Dindo classification and reoperation (p < 0.05). Female Sexual Function Index, and the Pelvic Organ Prolapse Symptom Score were different between the groups (p < 0.05).

Conclusions

This study showed that there is no difference between two surgical techniques in apical prolapse cure rates. However, the LLS seem preferable in terms of the Female Sexual Function Index, Pelvic Organ Prolapse Symptom Score, reoperation, and complications. We need larger sample size studies in terms of incidence of complications and reoperation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author, [Kübra BAKİ ERİN], upon reasonable request.

References

  1. Barber MD, Maher C (2013) Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J 24:1783–1790. https://doi.org/10.1007/s00192-013-2169-9

    Article  PubMed  Google Scholar 

  2. Nygaard I (2008) Prevalence of symptomatic pelvic floor disorders in US women. JAMA 300:1311. https://doi.org/10.1001/jama.300.11.1311

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Handa VL, Garrett E, Hendrix S et al (2004) Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women. Am J Obstet Gynecol 190:27–32. https://doi.org/10.1016/j.ajog.2003.07.017

    Article  PubMed  Google Scholar 

  4. Smith FJ, Holman CDJ, Moorin RE, Tsokos N (2010) Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol 116:1096–1100. https://doi.org/10.1097/AOG.0b013e3181f73729

    Article  PubMed  Google Scholar 

  5. FDA (2022) Urogynecologic surgical mesh implants. https://www.fda.gov/medical-devices/implants-and-prosthetics/urogynecologic-surgical-mesh-implants. Accessed 16 Jun 2022

  6. Kapandji M (1967) Treatment of urogenital prolapse by colpo-isthmo-cystopexy with transverse strip and crossed, multiple layer, ligamento-peritoneal douglasorrhaphy. Ann Chir 21:321–328

    CAS  PubMed  Google Scholar 

  7. Dubuisson J-B, Yaron M, Wenger J-M, Jacob S (2008) Treatment of genital prolapse by laparoscopic lateral suspension using mesh: a series of 73 patients. J Minim Invasive Gynecol 15:49–55. https://doi.org/10.1016/j.jmig.2007.11.003

    Article  PubMed  Google Scholar 

  8. Richter K (1968) The surgical anatomy of the vaginaefixatio sacrospinalis vaginalis. A contribution to the surgical treatment of vaginal blind pouch prolapse. Geburtshilfe Frauenheilkd 28:321–327

    CAS  PubMed  Google Scholar 

  9. Sederl J (1958) Surgery in prolapse of a blind-end vagina. Geburtshilfe Frauenheilkd 18:824–828

    CAS  PubMed  Google Scholar 

  10. Zhang W, Cheon WC, Zhang L et al (2022) Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis. Int Urogynecol J 33:3–13. https://doi.org/10.1007/s00192-021-04823-w

    Article  CAS  PubMed  Google Scholar 

  11. Chen Y, Peng L, Zhang J et al (2022) Sacrospinous ligament fixation vs uterosacral ligaments suspension for pelvic organ prolapse: a systematic review and meta-analysis. Urology 166:133–139. https://doi.org/10.1016/j.urology.2022.04.012

    Article  PubMed  Google Scholar 

  12. Dubuisson J, Eperon I, Dällenbach P, Dubuisson J-B (2013) Laparoscopic repair of vaginal vault prolapse by lateral suspension with mesh. Arch Gynecol Obstet 287:307–312. https://doi.org/10.1007/s00404-012-2574-1

    Article  PubMed  Google Scholar 

  13. Swift S, Morris S, McKinnie V et al (2006) Validation of a simplified technique for using the POPQ pelvic organ prolapse classification system. Int Urogynecol J 17:615–620. https://doi.org/10.1007/s00192-006-0076-z

    Article  Google Scholar 

  14. Verit FF, Verit A (2007) Validation of the female sexual function index in women with chronic pelvic pain. J Sex Med 4:1635–1641. https://doi.org/10.1111/j.1743-6109.2007.00604.x

    Article  PubMed  Google Scholar 

  15. Özengin N, Kaya S, Orhan C et al (2017) Turkish adaptation of the Pelvic Organ Prolapse Symptom Score and its validity and reliability. Int Urogynecol J 28:1217–1222. https://doi.org/10.1007/s00192-016-3251-x

    Article  PubMed  Google Scholar 

  16. Dindo D (2014) The Clavien–Dindo Classification of Surgical Complications. In: Treatment of Postoperative Complications After Digestive Surgery. Springer London, London, pp 13–17

  17. Wattiez A, Mashiach R, Donoso M (2003) Laparoscopic repair of vaginal vault prolapse. Curr Opin Obstet Gynecol 15:315–319. https://doi.org/10.1097/01.gco.0000084246.09900.06

    Article  PubMed  Google Scholar 

  18. Higgs PJ, Chua H-L, Smith ARB (2005) Long term review of laparoscopic sacrocolpopexy. BJOG 112:1134–1138. https://doi.org/10.1111/j.1471-0528.2005.00646.x

    Article  CAS  PubMed  Google Scholar 

  19. Mereu L, Dalpra F, Terreno E et al (2018) Mini-Laparoscopic Repair of Apical Pelvic Organ Prolapse (POP) by Lateral Suspension with Mesh. Facts Views Vis Obgyn 10:139–145

    CAS  PubMed  Google Scholar 

  20. Simoncini T, Russo E, Mannella P, Giannini A (2016) Robotic-assisted apical lateral suspension for advanced pelvic organ prolapse: surgical technique and perioperative outcomes. Surg Endosc 30:5647–5655. https://doi.org/10.1007/s00464-016-4924-8

    Article  PubMed  Google Scholar 

  21. Maher CF, Qatawneh AM, Dwyer PL et al (2004) Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Am J Obstet Gynecol 190:20–26. https://doi.org/10.1016/j.ajog.2003.08.031

    Article  PubMed  Google Scholar 

  22. Mereu L, Tateo S, D’Alterio MN et al (2020) Laparoscopic lateral suspension with mesh for apical and anterior pelvic organ prolapse: a prospective double center study. Eur J Obstetrics Gynecol Reproductive Biol 244:16–20. https://doi.org/10.1016/j.ejogrb.2019.10.026

    Article  Google Scholar 

  23. Veit-Rubin N, Dubuisson J-B, Gayet-Ageron A et al (2017) Patient satisfaction after laparoscopic lateral suspension with mesh for pelvic organ prolapse: outcome report of a continuous series of 417 patients. Int Urogynecol J 28:1685–1693. https://doi.org/10.1007/s00192-017-3327-2

    Article  PubMed  Google Scholar 

  24. Miedel A, Tegerstedt G, Mörlin B, Hammarström M (2008) A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse. Int Urogynecol J 19:1593–1601. https://doi.org/10.1007/s00192-008-0702-z

    Article  Google Scholar 

  25. Diwadkar GB, Barber MD, Feiner B et al (2009) Complication and reoperation rates after apical vaginal prolapse surgical repair. Obstet Gynecol 113:367–373. https://doi.org/10.1097/AOG.0b013e318195888d

    Article  PubMed  Google Scholar 

  26. Campagna G, Vacca L, Panico G et al (2021) Laparoscopic lateral suspension for pelvic organ prolapse: a systematic literature review. Eur J Obstetrics Gynecol Reproductive Biol 264:318–329. https://doi.org/10.1016/j.ejogrb.2021.07.044

    Article  Google Scholar 

  27. Yassa M, Tug N (2019) Uterus-preserving laparoscopic lateral suspension with mesh operation in pelvic organ prolapse: initial experience in a single tertiary center with a median 24-month follow-up. Geburtshilfe Frauenheilkd 79:983–992. https://doi.org/10.1055/a-0941-3485

    Article  PubMed  PubMed Central  Google Scholar 

  28. Morgan DM, Rogers MAM, Huebner M et al (2007) Heterogeneity in anatomic outcome of sacrospinous ligament fixation for prolapse. Obstet Gynecol 109:1424–1433. https://doi.org/10.1097/01.AOG.0000264066.89094.21

    Article  PubMed  Google Scholar 

  29. Sze E, Karram M (1997) Transvaginal repair of vault prolapse: a review. Obstetrics Gynecol 89:466–475. https://doi.org/10.1016/S0029-7844(96)00337-7

    Article  CAS  Google Scholar 

  30. Pulatoğlu Ç, Yassa M, Turan G et al (2021) Vaginal axis on MRI after laparoscopic lateral mesh suspension surgery: a controlled study. Int Urogynecol J 32:851–858. https://doi.org/10.1007/s00192-020-04596-8

    Article  PubMed  Google Scholar 

  31. Baumann M, Salvisberg C, Mueller M, Kuhn A (2009) Sexual function after sacrospinous fixation for vaginal vault prolapse: bad or mad? Surg Endosc 23:1013–1017. https://doi.org/10.1007/s00464-008-0108-5

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the Ondokuz Mayıs University administrator and BAP unit for their support for allowing the study to be conducted. The authors also thank medical illustrator Dr. Dilek BAŞAR for her surgical technique drawings.

Funding

This project was supported by Ondokuz Mayıs University Scientific Research Projects (PYO.TIP.1906.19.006).

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Trabzon Kanuni Health Practice and Research Center, University of Health Sciences, Trabzon, Turkey

    Kübra Baki Erin, Recep Erin & Deniz Kulaksiz

  2. Department of Obstetrics and Gynecology, Medical School, Ondokuz Mayıs University, Samsun, Turkey

    Ayşe Şeyma Taştan, Yunus Katırcı, Ayşe Zehra Özdemir, Davut Güven & Mesut Önal

  3. Department of Urology, Medicine Faculty, Ondokuz Mayıs University, Samsun, Turkey

    Kadir Önem

Authors
  1. Kübra Baki Erin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayşe Şeyma Taştan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yunus Katırcı
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ayşe Zehra Özdemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Davut Güven
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kadir Önem
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mesut Önal
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Recep Erin
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Deniz Kulaksiz
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [KBE], [AŞT], [YK], [AZÖ], [DG], [KÖ], [MÖ] and, [DK], [RE]. The first draft of the manuscript was written by [KBE], [AZÖ], [RE], [DK] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kübra Baki Erin.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Ondokuz Mayıs University. (01.01.2021-2020/768).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baki Erin, K., Taştan, A.Ş., Katırcı, Y. et al. Comparison of 2-year follow-up outcomes of laparoscopic lateral suspension and sacrospinous fixation in apical compartment prolapse: an observational study. Arch Gynecol Obstet 307, 1859–1865 (2023). https://doi.org/10.1007/s00404-023-06958-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-023-06958-1

Keywords

Search

Navigation