Comparison of classical and anchorage methods in sacrospinous ligament fixation

Abstract

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.