To explore the safety and efficiency of modified sacrospinous ligament fixation (MSSF) for apical prolapse.
It’s a retrospective cohort study. Patients diagnosed with apical prolapse from 2014 to 2019 were recruited and divided into three groups, those are sacrospinous ligament fixation (SSF), MSSF and laparoscopic sacral hysteropexy (LSH). All surgical characteristics were obtained and information concerning complications was collected and compared among these three groups.
A total of 710 patients were collected eventually, including 108 in SSF group, 260 in LSH and 342 in MSSF. MSSF and SSF group cost less surgical time(P<0.001) and hospital stay(P<0.001). All these three methods can significant change the prolapse with point C(P<0.001). Prevalence of Vaginal and pelvic pain after surgery were higher in group SSF (8/108 (7.41%)) (P=0.028), urinary incontinence seemed much higher in group LSH (22/260 (8.46%)) (P=0.010). In group LSH, there were more patients suffered from constipation and dyschezia after surgery, the prevalence were 18/260 (6.92%) (P=0.048). Recurrence of POP in group MSSF (15/324 (4.39%)) and group LSH (12/260 (4.62%)) were much lower than SSF group (16/108 (14.81%)) (P<0.001).
the efficacy of MSSF is commendable with low recurrence of POP and few complications in long-term follow-up.

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