Surgical Outcomes Within ۱ Year After Native-Tissue Apical Suspension for Pelvic Organ Prolapse: Sacrospinous Ligament Fixation Versus Uterosacral Ligament Suspension

Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could negatively affect the quality of life in these patients. This study aimed to assess the surgical outcomes of native-tissue apical suspension by sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS).Materials & Methods: This prospective cohort study was conducted to evaluate the outcomes of native-tissue apical suspension for pelvic organ prolapse within one year after the surgery from March ۲۰۱۷ to July ۲۰۱۹ at Imam Khomeini hospital, an academic hospital of Tehran University of Medical Sciences, Tehran, Iran. Inclusion criteria were patients with uterine prolapse at Stage ۲ or ۳ according to the Pelvic Organ Prolapse Quantification System (POP–Q) who planned for total vaginal hysterectomy and apical suspension using uterosacral ligament suspension (ULS) or sacrospinous ligament fixation (SSLF) with no history of pelvic organ prolapse surgery. The main outcome was surgical consequences within ۱ year after surgery.Results: There was no significant difference between the two groups in terms of relapse of anterior, posterior, or apical compartment prolapse. According to the clinical recurrence, although vaginal bulging and pressure were more common in sacrospinous ligament fixation (SSLF) group, the difference was not significant. The number of patients with severe buttock and pelvic pain was significantly higher in the sacrospinous ligament fixation (SSLF) group.Conclusion: sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are both optimal procedures with the same complications and similar surgical outcomes; however, uterosacral ligament suspension (ULS) had lower post-operative pelvic pain, and also the number of retreatment was lower in this group.