Related Experiment Video
Updated: Jul 17, 2026
Development of a Uterosacral Ligament Suspension Rat Model
Published on: August 17, 2022
Mid-Term Outcomes of Laparoscopic Versus Vaginal Uterosacral Ligament Suspension for Pelvic Organ Prolapse: A
Yiwei Zhang1, Jinbowen Yan1, Rusha Yin1
1National Clinical Research Center for Women's Health and Obstetric and Gynecologic Diseases, Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, State Key Laboratory of Common Mechanism Research of Major Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Introduction And Hypothesis:
Comparative data regarding the optimal surgical route for uterosacral ligament suspension (USLS) remain limited. This study compared mid-term efficacy and safety between laparoscopic (L-USLS) and vaginal (V-USLS) for apical pelvic organ prolapse (POP), utilizing propensity score overlap-weighted (PS-OW) to minimize selection bias.
Methods:
This retrospective cohort study included patients with symptomatic stage II or higher POP undergoing concurrent hysterectomy with L-USLS (n = 135) or V-USLS (n = 43). PS-OW balanced baseline characteristics. Primary outcome was composite success. Secondary outcomes included perioperative parameters, anatomic results, patient-reported outcomes, and complications.
Results:
After PS-OW, all baseline covariates were well balanced. L-USLS demonstrated significantly shorter total operative time. L-USLS also enabled concomitant adnexal surgery in all patients without additional assistance. At a mean follow-up of approximately 3 years, composite success (86.1% vs 85.1%), anatomical success (91.8% vs 94.7%), subjective success (86.2% vs 85.1%), and retreatment (4.1% vs 1.6%) rates were comparable between groups (all P > 0.05). V-USLS required routine intraoperative cystoscopy, and two cases of postoperative ureteral obstruction needing intervention.
Conclusions:
L-USLS and V-USLS provide equivalent mid-term outcomes for apical POP. L-USLS presents superior perioperative advantages and greater flexibility for concomitant adnexal surgery. V-USLS avoids a transabdominal approach but requires routine cystoscopy and carries ureteral obstruction risks.
