Comparison of postoperative recovery and complications: laparoscopic sacrocolpopexy versus transvaginal sacrospinous ligament suspension.

OBJECTIVE

The goal of this study was to determine whether functional recovery and complication rates differed between laparoscopic sacrocolpopexy (LSC) and transvaginal sacrospinous ligament suspension (TSS) in patients with moderate-to-severe uterine prolapse and vaginal wall prolapse.

METHODS

We conducted a retrospective cohort study of 321 patients who underwent surgery between April 2021 and February 2023. Participants were divided into an LSC group (n=163) and a TSS group (n=158). Since pelvic organ prolapse may occur following childbirth, complication and recurrence rates were compared between groups. Factors associated with recurrence were analyzed using logistic regression.

RESULTS

Compared to LSC, TSS had shorter operation time, less blood loss, and faster return of flatus. Both groups improved in pelvic organ prolapse quantification scores, pelvic floor distress inventory-20, and pelvic organ prolapse/urinary incontinence sexual questionnaire-12, with greater improvement in the LSC group. TSS was associated with higher rates of urinary incontinence and recurrence (5.52% vs. 13.29%). Multivariate analysis showed TSS, prior pelvic surgery, and combined compartment prolapse were risk factors for recurrence, while age <60 and body mass index <24 kg/m2 were protective.

CONCLUSION

In patients with moderate-to-severe uterine and vaginal wall prolapse who are medically fit, LSC provides superior pelvic floor anatomical restoration, quality of life improvement, and recurrence control compared to TSS. For patients who cannot tolerate laparoscopic surgery, TSS remains a safe alternative, with both procedures demonstrating comparable overall safety.