%0 Journal Article
%T Serious Complications and Recurrence following Sacrospinous Ligament Fixation for the Correction of Apical Prolapse.
%A De Gracia S
%A Fatton B
%A Cosson M
%A Campagne-Loiseau S
%A Ferry P
%A Lucot JP
%A Debodinance P
%A Panel L
%A Deffieux X
%A Garbin O
%A Lamblin G
%A Carlier-Guérin C
%A Ramanah R
%A Fauconnier A
%A Serrand C
%A Fritel X
%A de Tayrac R
%J J Clin Med
%V 12
%N 2
%D Jan 2023 6
%M 36675397
%F 4.964
%R 10.3390/jcm12020468
%X 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.