Abstract
Purpose: The aim of this retrospective clinical study is to assess clinical outcomes, patient satisfaction between laparoscopic lateral suspension (LLS) with mesh and laparoscopic high uterosacral ligament suspension (LHUS) for apical prolapse with or without anterior prolapse.
Methods: Patients who underwent LLS with mesh or LHUS from 2019 to 2023 at the Second West China Hospital of Sichuan University were enrolled in this retrospective study. The objective outcomes were evaluated based on the anatomical success rate according to the Pelvic Organ Prolapse Quantification System (POP-Q). The subjective outcomes were assessed using the Pelvic Floor Distress Inventory (PFDI-20) questionnaire, Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Global Impression of Improvement (PGI-I) scores and complications rate. Complications were defined according to the Clavien-Dindo scale. The outcomes of postoperative 3, 6 and 12 months were analyzed retrospectively.
Results: The objective and subjective outcomes indicated improvements in both groups. There was no statistically significant difference between the two groups in the change of subjective outcomes. The short-term objective and subjective outcomes for both techniques were found to be comparable. The anatomical success rate for apical and anterior prolapse was 93.85% in LHUS group, 93.44% in LLS group. LLS demonstrated a superior effect on the degree of postoperative point Ba improvement comparing to LHUS.
Conclusion: LHUS and LLS are effective, safe surgical techniques for apical prolapsed, with or without anterior prolapsed, exhibiting low complication rates and high anatomic curative rates. LLS demonstrated certain advantages over LHUS in anterior improvement and symptom improvement compared to LHUS.