Professor Seoul National University Hospital Seoul, Seoul-t'ukpyolsi, Republic of Korea
Objectives: To evaluate surgical outcomes according to the surgical route for uterosacral ligament suspension (USLS) surgery.
Methods: This retrospective cohort study included 456 women who underwent USLS for pelvic organ prolapse quantification stage 2-4 prolapse and completed at least 4-month follow-up. The primary outcome was surgical failure defined as the presence of vaginal bulging symptoms, apical descent >1/2 of total vaginal length, anterior or posterior vaginal descent beyond the hymen, or retreatment for prolapse. Secondary outcome was perioperative outcomes and complications requiring intervention.
Results: Laparoscopic USLS was performed in 100 women and vaginal USLS was performed in 356 women. The laparoscopic USLS group was younger and had less advanced prolapse. The laparoscopic USLS group also had a lower rate of concomitant procedures. However, operating time was longer (p < .01) and the amount of blood loss was greater (p=.03) in the laparoscopic USLS group. During the median 3-year follow-up period, there was no difference in the rates of surgical failure between the two groups (27.0% vs 22.8%, p=.51). Overall complication rates requiring intervention were also similar between the two groups.
Conclusions: The laparoscopic and vaginal USLS were comparable in efficacy and safety.
