Comparison of the Effectiveness of Sacrospinous Ligament Fixation and Sacrocolpopexy: a Meta-analysis

Overview

Journal Int Urogynecol J

Publisher Springer

Specialties Gynecology & Obstetrics
Urology

Date 2021 Jun 3

PMID 34081163

Citations 14

Authors

Wenju Zhang

Willy Cecilia Cheon

Li Zhang

Xiaozhong Wang

Yuzhen Wei

Chaoxia Lyu

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: Sacrocolpopexy and sacrospinous ligament fixation (SSLF) have been used for the restoration of apical support. Studies comparing sacrocolpopexy and SSLF have reported conflicting results. We aim to assess the current evidence regarding efficiency and the complications of sacrocolpopexy compared with SSLF.

Methods: We searched PubMed, Embase, and Cochrane Library and performed a systematic review meta-analysis to assess the two surgical approaches.

Results: 5Five randomized controlled trials, 8 retrospective studies, and 2 prospective studies including 4,120 cases were identified. Compared with abdominal sacrocolpopexy (ASC), SSLF was associated with a lower success rate (88.32% and 91.45%; OR 0.52; 95% CI 0.29-0.95; p = 0.03), higher recurrence (11.58% and 8.32%; OR 1.97; 95% CI 1.04-3.46; p = 0.04), and dyspareunia rate (14.36% and 4.67%; OR 3.10; 95% CI 1.28-7.50; p = 0.01). Patients in this group may benefit from shorter operative time (weighted mean difference -25.08 min; 95% CI -42.29 to -7.88; p = 0.004), lower hemorrhage rate (0.85% and 2.58%; OR 0.45; 95% CI 0.25-0.85; p = 0.009), wound infection rate (3.30% and 5.76%; OR 0.55; 95% CI 0.39-0.77; p = 0.0005), and fewer gastrointestinal complications (1.33% and 6.19%; OR 0.33; 95% CI 0.15-0.76; p = 0.009).

Conclusion: Both sacrocolpopexy and SSLF offer an efficient alternative to the restoration of apical support. When anatomical durability and sexual function is a priority, ASC may be the preferred option. When considering factors of mesh erosion, operative time, gastrointestinal complications, hemorrhage, and wound infections, SSLF may be the better option.

Citing Articles

Sacrocolpopexy: The Way I Do It.

Shahid U, Chen Z, Maher C Int Urogynecol J. 2024; 35(11):2107-2123.

PMID: 39404818 PMC: 11638296. DOI: 10.1007/s00192-024-05922-0.

Cadaveric Insights into Pudendal Nerve Variations for Sacrospinous Ligament Fixation: A Case Series.

Ozcivit Erkan I, Gorgun E Int Urogynecol J. 2024; 35(12):2385-2394.

PMID: 39254843 DOI: 10.1007/s00192-024-05919-9.

Complications of Pelvic Prolapse Surgery Using Mesh: A Systematic Review.

Dabica A, Balint O, Olaru F, Secosan C, Balulescu L, Brasoveanu S J Pers Med. 2024; 14(6).

PMID: 38929843 PMC: 11205245. DOI: 10.3390/jpm14060622.

Precision in Practice: The Critical Role of Mesh and Procedure Type Specification in Urogynecological Surgeries and Research.

Rotem R, Galvin D, Daykan Y, Al-Shukaili S, OReilly B, OSullivan O Int Urogynecol J. 2024; 35(9):1763-1767.

PMID: 38811409 PMC: 11420388. DOI: 10.1007/s00192-024-05820-5.

Mobility analysis of a posterior sacrospinous fixation using a finite element model of the pelvic system.

Lallemant M, Shimojyo A, Mayeur O, Ramanah R, Rubod C, Kerbage Y PLoS One. 2024; 19(3):e0299012.

PMID: 38512958 PMC: 10956756. DOI: 10.1371/journal.pone.0299012.

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