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

Abstract

Background: Pelvic organ prolapse (POP) is a common pathology in the female population. Sacrospinous ligament fixation (SSLF) is one of the traditional transvaginal procedures for POP and high sacrospinous ligament fixation (h-SSLF) optimizes it using an antegrade reusable suturing device (ARSD-Ney). Previous studies on h-SSLF have focused on the correction of anatomical positions, with less assessment of patients' function, quality of life and complications. In this study, we evaluated post-operative complications, function, and quality-of-life after h-SSLF to confirm the safety and effectiveness of it. Methods: This was a retrospective cohort study that included 71 patients between 2018 and 2021: 50 patients for h-SSLF and 21 patients for laparoscopic sacrocolpopexy (LSC) according to patient age and background, POP-Q stage, patient preference, and so on. A clinical evaluation took place before surgery and was repeated at 6 and 12 months postoperatively. Intra-and post-operative complications and anatomical results were recorded. Patients completed self-administered questionnaires for functional pelvic problems [Pelvic Floor Disability Index-20 (PFDI-20)], quality of life [Pelvic Floor Impact Questionnaire-7 (PFIQ-7)], and sexual function [Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12)] at each medical visit.Results: Patients in both h-SSLF and LSC groups were similar in terms of demographic characteristics except for surgery time (86.04±28.70 vs. 153.19±54.88, P<0.05), postoperative indwelling catheter time (3.88±1.65 vs. 4.90±1.84, P<0.05), and hospital stay (8.94±2.38 vs. 10.57±2.06, P<0.05). There were no statistically significant differences between the 2 groups in scores of PFDI-20, PFIQ-7, and PISQ-12 at preand post-operative 6 and 12 months (P>0.05). Functional pelvic problems (PFDI-20 scores) and their impact on patients' quality of life (PFIQ-7 scores) significantly improved at 6 and 12 months postoperatively (P<0.05).Improvements in sexual activity were noted at 6 and 12 months postoperatively (P<0.05).Conclusions: This retrospective cohort study confirmed the positive results of h-SSLF in terms of improvement in function and quality of life following treatment for pelvic organ prolapse.

A preliminary clinical report of transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation in the treatment of moderate and severe pelvic organ prolapse

“…This outcome may be related to the increased difficulty of transvaginal single-port laparoscopic surgery. The intraoperative blood loss of this study was 134.44 ± 111.21 ml, which was higher than the 92.3 ± 91.4 ml of 453 SSLF patients (74) and 86.80 ± 91.44 of 50 H-SSLF patients (76). This outcome may be related to factors such as increased surgical difficulty, small sample size, and initial surgery.…”

“…In this study, the data was derived from 18 patients, as shown in Tables 1, 2. The average operation duration was 192.78 ± 38.81 min, which was longer than the reported 92.3 ± 31.5 min of 453 patients with SSLF (74), longer than the 122.8 ± 36.1 min of 57 SSLF patients (75), and longer than the 86.04 ± 28.70 min of 50 patients with H-SSLF (76). This outcome may be related to the increased difficulty of transvaginal single-port laparoscopic surgery.…”

Laparoscopic Pectopexy versus Vaginal Sacrospinous Ligament Fixation in the Treatment of Apical Prolapse

“…Injury to the pudendal nerve and its branches, which surround the sacral plexus, can explain buttock pain. Following SSLF, a 10% rate was recorded by Ping Wang et al [22], but this number dropped to 0 at 6 and 12 months postoperatively. One incidence of persistent thigh pain was reported by Feiner et al and which gradually settled after 12 months [14].…”