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

Author:

De Gracia Susie,Fatton Brigitte,Cosson Michel,Campagne-Loiseau Sandrine,Ferry Philippe,Lucot Jean-PhilippeORCID,Debodinance Philippe,Panel Laure,Deffieux Xavier,Garbin Olivier,Lamblin Géry,Carlier-Guérin Caroline,Ramanah Rajeev,Fauconnier Arnaud,Serrand ChrisORCID,Fritel XavierORCID,de Tayrac RenaudORCID

Abstract

Objective: To evaluate the rates of serious complications and reoperation for recurrence following sacrospinous ligament fixation (SSLF) for apical pelvic organ prolapse. Methods: This was a national registry ancillary cohort comparative study. The VIGI-MESH registry includes data from 24 French health centers prospectively collected between May 2017 and September 2021. Time to occurrence of a serious complication or reoperation for genital prolapse recurrence was explored using the Kaplan–Meier curve and Log-rank test. The inverse probability of treatment weighting, based on propensity scores, was used to adjust for between-group differences. Results: A total of 1359 women were included and four surgical groups were analyzed: Anterior SSLF with mesh (n = 566), Anterior SSLF with native tissue (n = 331), Posterior SSLF with mesh (n = 57), and Posterior SSLF with native tissue (n = 405). Clavien–Dindo Grade III complications or higher were reported in 34 (2.5%) cases, with no statistically significant differences between the groups. Pelvic organ prolapse recurrence requiring re-operation was reported in 44 (3.2%) women, this was higher following posterior compared with anterior SSLF (p = 0.0034). Conclusions: According to this large database ancillary study, sacrospinous ligament fixation is an effective and safe surgical treatment for apical prolapse. The different surgical approaches (anterior/posterior and with/without mesh) have comparable safety profiles. However, the anterior approach and the use of mesh were associated with a lower risk of reoperation for recurrence compared with the posterior approach and the use of native tissue, respectively.

Funder

Agence Nationale de Sécurité du Médicament et des Produits de Santé

Publisher

MDPI AG

Subject

General Medicine

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Anterior sacrospinous ligament fixation by the vaginal route in ten steps;Journal of Gynecology Obstetrics and Human Reproduction;2023-12

2. Comparison of Anterior and Posterior Approach Bilateral Sacrospinous Ligament Fixation for Vaginal Vault Prolapse;Clinical and Experimental Obstetrics & Gynecology;2023-10-19

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