Medium‐term outcomes of laparoscopic sacrocolpopexy or sacrohysteropexy versus vaginal sacrospinous ligament fixation for middle compartment prolapse

Objective To compare laparoscopic sacrocolpopexy ( LSC ) or sacrohysteropexy ( LSH ) with vaginal sacrospinous ligament fixation ( VSSLF ) for middle compartment pelvic organ prolapse ( POP ). Methods Data were retrospectively reviewed from patients with POP (stage 3 or worse) who underwent LSC , LSH , or VSSLF at a center in Shanghai between January 2009 and March 2014. POP quantification ( POP ‐Q) and Pelvic Floor Distress Inventory scores were compared at the 2‐year follow‐up. Results Data were available for the 2‐year follow‐up for 102 LSC , 11 LSH , and 94 VSSLF procedures. Compared with patients who had undergone VSSLF , those who had undergone LSC / LSH had better POP ‐Q C values ( P< 0.001), longer total vaginal length ( TVL ) ( P< 0.001), and lower Aa and Ba scores ( P= 0.003 and P= 0.002, respectively). Apical compartment and overall success rates of LSC / LSH and VSSLF did not differ significantly. Quality of life was improved in both groups ( P< 0.001). Both groups achieved symptomatic relief, although bowel and urinary functions were significantly improved only in the VSSLF group ( P< 0.001 for both). More patients in the LSC / LSH group were sexually active at 2 years ( P< 0.001); improvement in sex life was similar between the groups. Conclusion Although LSC / LSH achieved longer TVL , both groups achieved the same success rate and improvement in quality of life. Specifically, VSSLF yielded a significant improvement in bowel and urinary function.