Sacrospinous Ligament Fixation Using an Anchor Versus Suture-Capturing Device: A Prospective Cohort Study

Area of Science:

• Urogynecology
• Pelvic Floor Surgery
• Minimally Invasive Gynecological Procedures

Background:

• Pelvic organ prolapse (POP) significantly impacts women's quality of life.
• Sacrospinous ligament fixation is a surgical option for POP management.
• Comparing fixation devices is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To compare persistent gluteal and posterior thigh pain between anchor-based and suture-capturing devices for sacrospinous ligament fixation.
• To evaluate procedural efficacy and postoperative complications at 1 year.
• To determine if device type influences long-term pain and failure rates.

Main Methods:

• Prospective cohort study of patients from a randomized controlled trial.
• Follow-up at 1 year post-sacrospinous ligament fixation.
• Assessment of pain (Numerical Rating Scale) and symptom scores (PFDI-20, PFQI-7).
• Definition of composite surgical failure including prolapse recurrence and retreatment.

Main Results:

• 91% of patients completed 1-year follow-up.
• No significant increase in gluteal or posterior thigh pain compared to baseline for either device group.
• Surgical failure occurred in two patients (anchor group), with no significant difference between devices.
• Both anchor and suture devices demonstrated comparable improvements in symptom scores.

Conclusions:

• Persistent gluteal or posterior thigh pain is uncommon 12 months after sacrospinous fixation.
• Surgical failure rates are low at 1 year and not associated with the type of fixation device used.
• Anchor-based and suture-capturing devices offer similar safety and efficacy profiles for sacrospinous ligament fixation.