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- Title
Serious Complications and Recurrence following Sacrospinous Ligament Fixation for the Correction of Apical Prolapse.
- Authors
De Gracia, Susie; Fatton, Brigitte; Cosson, Michel; Campagne-Loiseau, Sandrine; Ferry, Philippe; Lucot, Jean-Philippe; Debodinance, Philippe; Panel, Laure; Deffieux, Xavier; Garbin, Olivier; Lamblin, Géry; Carlier-Guérin, Caroline; Ramanah, Rajeev; Fauconnier, Arnaud; Serrand, Chris; Fritel, Xavier; de Tayrac, Renaud
- 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.
- Subjects
COLPORRHAPHY; PELVIC organ prolapse; LIGAMENTS; LOG-rank test; DATABASES
- Publication
Journal of Clinical Medicine, 2023, Vol 12, Issue 2, p468
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm12020468