Comparison of Unilateral and Bilateral Sacrospinous Ligament Fixation Using Minimally Invasive Anchorage

Abstract

Objective The aim of this study was to determine the effectiveness of a newly developed anchoring system for unilateral sacrospinous ligament fixation (USSLF) and bilateral sacrospinous ligament fixation (BSSLF) procedures. Material and Methods Ninety-three patients with pelvic prolapse who were treated surgically with the Anchorsure System® between 2013 and 2018 were included in the study. USSLF was performed in 52 patients (group 1), and BSSLF was performed in 41 patients (group 2). Pelvic organ prolapse was assessed preoperatively and 6 months postoperatively. Results There were no significant differences between groups 1 and 2 with regard to age, parity, and demographic characteristics. Anatomical improvement rates were similar, irrespective of the type of SSLF used. No bleeding requiring blood transfusion or organ injuries occurred in any patient. Three patients in the group that received BSSLF developed small asymptomatic cystoceles (grade 1 to 2); there was no recurrence of rectoceles or enteroceles. Mild cystocele was found in 1 patient from the USSLF group. There was no significant difference between the groups with respect to the recurrence of cystocele. Recurrence of vaginal vault prolapse was found in 2 patients from the USSLF group (3.84%). There was no significant difference between the groups with regard to recurrence. Febrile morbidity, clinical outcomes, blood loss, duration of operation, intraoperative complications, and length of hospital stay were similar for the two groups. Conclusions Unilateral and bilateral SSLF techniques produce similar clinical outcomes. USSLF and BSSLF performed using the new anchoring system are safe and effective methods to treat pelvic organ prolapse.

Function, quality-of-life and complications after sacrospinous ligament fixation using an antegrade reusable suturing device (ARSD-Ney) at 6 and 12 months: a retrospective cohort study

“…The study of Salman et al (19) reported that no rectal injury occurred intraoperatively, which is consistent with our results. The data regarding functional outcome for the bowel (CRADI-8 scores) after h-SSLF and LSC showed hardly any improvement for most patients.…”

Serious Complications and Recurrence following Sacrospinous Ligament Fixation for the Correction of Apical Prolapse

“…In our series, 81.1% of the SSLF were performed bilaterally. Our results are comparable to Salman’s study, which compared unilateral versus bilateral SSLF, reporting recurrence of vaginal vault prolapse in two patients (3.84%) in the unilateral group and no recurrences for the bilateral group, with no statistically significant differences between the two groups with a follow-up of 6 months after surgery [ 21 ].…”

Perioperative and Long-Term Anatomical and Subjective Outcomes of Laparoscopic Pectopexy and Sacrospinous Ligament Suspension for POP-Q Stages II–IV Apical Prolapse

“…Mehmet Baki et al [45] demonstrated that bilateral SSLF with mesh allowed to establish adequate pelvic support for genital prolapse and suggested that the vaginal axis may be closer to the original anatomical position. In contrast, Salman et al [46] proved that unilateral and bilateral SSLF techniques are associated with similar clinical outcomes. In a recently published meta-analysis involving 4120 patients after SSLF and SCP, SSLF was associated with lower success rate (88.32% vs. 91.45%), higher recurrence (11.58% vs. 8.32%) and dyspareunia (14.36% vs. 4.67%) rates, shorter operative time, lower hemorrhage and wound infection rate and lower and fewer gastrointestinal complications [42].…”