Comparison of classical and anchorage methods in sacrospinous ligament fixation

Yıl 2024, Cilt: 6 Sayı: 4, 278 - 281, 29.07.2024

Ramazan Adan Fatih Şahin

https://doi.org/10.38053/acmj.1492288

Öz

Aims: Pelvic organ prolapse (POP) is a common condition that affects the quality of life in women. As a natural consequence of the aging population, it is believed that POP will increase in the next 40 years. With the increase in life expectancy, there is an expected rise in reconstructive surgical procedures to correct pelvic floor disorders. POP can occur in three vaginal compartments: anterior, apical, and posterior. The apical compartment includes uterine prolapse, cervix, or vaginal cuff prolapse. Our primary objective was to compare the surgical outcomes of the method using the classic technique with pelvic floor anchorage (anchoring).
Methods: This retrospective cohort study consisted of women with POP-Q (Pelvic Organ Prolapse Quarejment) grade 2 and above in the apical compartment. In the sample size calculation, G power analysis was performed with α: 0.05 and 80% accuracy. Forty-eight women were included in the study, with 24 of them undergoing the classic method and the other 24 receiving sacrospinous ligament fixation (SSLF) using a pelvic floor anchoring device. The results of both surgical methods were compared in terms of anatomical recurrence.
Results: There was no statistically significant difference observed between the postoperative measurements of the C points. However, the difference in the C level between preoperative and postoperative measurements for patients who underwent the classic SSLF operation was statistically significantly higher compared to those who underwent the Anchorage SSLF procedure.
Conclusion: When comparing the classic and anchoring systems for the SSLF procedure, no difference was observed in terms of recurrence. However, the classic method was found to be more successful in restoring apical prolapse.

Anahtar Kelimeler

Apical prolapse, SSLF, pelvic organ prolapse

Kaynakça

• Pang H., Zhang L, Han S, et al. A nationwide population‐based survey on the prevalence and risk factors of symptomatic pelvic organ prolapse in adult women in China–a pelvic organ prolapse quantification system‐based study. Int J Gynaecol Obstet. 2021; 128(8):1313-1323.
• Peinado Molina RA, Hernández Martínez A, Martínez Vázquez S, Rodríguez Almagro J, Martínez Galiano JM. Pelvic floor dysfunction: prevalence and associated factors. BMC Public Health. 2023;14;23(1):2005. doi: 10.1186/s12889-023-16901-3
• Larouche M, Belzile E, Geoffrion R. Surgical management of symptomatic apical pelvic organ prolapse: a systematic review and meta-analysis. Obstet Gynecol. 2021;137(6):1061-1073.
• Şahin F, Özdemir S, Doğan O. Should sacrouterine plication be added to lateral suspension surgery? a prospective study. J Obstet Gynaecol Res. 2024;50(6):1042-1050.
• De Gracia S, Fatton B, Cosson M, et al. Serious complications and recurrence following sacrospinous ligament fixation for the correction of apical prolapse. J Clin Med. 2023;12(2):468.
• Holt E. US FDA rules manufacturers to stop selling mesh devices. Lancet. 2019;27:393.
• Husby KR, Larsen MD, Lose G, Klarskov N. Surgical treatment of primary uterine prolapse: a comparison of vaginal native tissue surgical techniques. Int Urogynecol J. 2019;30(11):1887-1893.
• Coolen AWM, Bui BN, Dietz V, et al. The treatment of post-hysterectomy vaginal vault prolapse: a systematic review and meta-analysis. Int Urogynecol J. 2017;28(12):1767-1783.
• Wu CJ, Chang WC, Huang KJ, Hsieh YC, Wei LH, Sheu BC. Long-term follow-up of 453 patients with pelvic organ prolapse who underwent transvaginal sacrospinous colpopexy with Veronikis ligature carrier. Sci Rep. 2020;10(1):4997.
• Campbell J, Pedroletti C, Ekhed L, Nüssler E, Strandell A. Patient-reported outcomes after sacrospinous fixation of vault prolapse with a suturing device: a retrospective national cohort study. Int Urogynecol J. 2018;29(6):821-829.
• Mowat A, Wong V, Goh J, Krause H, Pelecanos A, Higgs P. A descriptive study on the efficacy and complications of the capio (Boston Scientific) suturing device for sacrospinous ligament fixation. Aust N Z J Obstet Gynaecol. 2018;58(1):119-124
• Chen Y, Peng L, Zhang J, Shen H, Luo D. Sacrospinous ligament fixation vs uterosacral ligaments suspension for pelvic organ prolapse: a systematic review and meta-analysis. Urology. 2022; 166(8):133-139.
• Salman S, Babaoglu B, Kumbasar S, et al. Comparison of unilateral and bilateral sacrospinous ligament fixation using minimally invasive anchorage. Geburtshilfe Frauenheilkd. 2019;79(9):976-982.
• Şahin F, Adan R, Bademler N, Demirel EA, Toplu Mİ, Mihmanlı V. Genital hiatus measurements predict cuff prolapse risk in prolapse surgery. J Surg Med. 2023;7(6):364-368.
• Huang LX, Guo M, Sha LX, Chen C, Lin XH, Dong XX. clinical effect of uterosacral and cardinal ligament fixation versus sacrospinous ligament fixation of vaginal vault prolapse: a retrospective analysis. Int J Clin Pract. 2023;3:1489928.
• Allahdin S, Herd D, Reid BA. Twenty-five sacrospinous ligament fixation procedures in a district general hospital: our experience. J Obstet Gynaecol. 2005;25(4):361-363.
• Zhang W, Cheon WC, Zhang L, Wang X, Wei Y, Lyu C. Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis. Int Urogynecol J. 2022;33(1):3-13.
• Senturk MB, Doğan O. Sacrospinous ligament fixation under local anesthesia in elderly patients at high risk of general anesthesia. J Invest Surg. 2020;33(1):1-7.
• Ren C, Song XC, Zhu L,et al. Prospective cohort study on the outcomes of sacrospinous ligament fixation using conventional instruments in treating stage pelvic organ prolapse. Zhonghua Fu Chan Ke Za Zhi. 2017;52(6):369-373.
• Greisen S, Axelsen SM, Bek KM, Guldberg R, Glavind-Kristensen M. Fast track sacrospinous ligament fixation: subjective and objective outcomes at 6 months. BMC Womens Health. 2021;21(1):154.