Transvaginal sacrospinous ligament fixation: Efficacy in treating pelvic prolapse and influence on patients' anxiety and depression.

BACKGROUND

Pelvic organ prolapse (POP) can lead to urinary incontinence, fecal incontinence, and other symptoms, affecting the quality of life, which results in anxiety and depression and other negative emotions in many patients. Trans-vaginal sacrospinous ligament suspension (VSSLS) involves securing the apex of the prolapsed vagina to the sacrospinous ligament to maintain the physiological axis of the vagina, help in repairing pelvic floor defects, and maintain the normal function of the pelvic floor, thereby alleviating patients' anxiety and depression.

AIM: To explore the effect of VSSLS in the treatment of POP and its influence on anxiety and depression among patients.

METHODS

Sixty patients with moderate to severe POP who underwent surgical treatment between January 2023 and June 2024 in Suzhou Ninth Hospital Affiliated to Soochow University were retrospectively enrolled in the study. According to treatment methods, they were divided into the control group (n = 30, treated with vaginal hysterectomy alone) and observation group (n = 30, treated with VSSLS combined with vaginal hysterectomy). The two groups were compared by baseline data, perioperative indicators, and postoperative pain intensity, prolapse distance before and after surgery, sexual function, pelvic function, anxiety, and depression.

RESULTS

No significant differences in baseline data, preoperative POP Quantification measurement value, Pelvic Floor Dysfunction Inventory 20 (PFDI-20), Pelvic Floor Impact Questionnaire 7 (PFIQ-7), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) scores were found between the two groups. The observation group had longer operation time and more intraoperative blood loss than the control group, the Visual Analog Scale score on postoperative day 1 was slightly higher in than in the control group. On the reexamination 3 months postoperatively, the POP Quantification measurement values in the observation group were lower than those in the control group (P < 0.05). Evaluation 6 months after surgery, the FSFI score was higher in the observation group than in the control group, the PFDI-20, PFIQ-7, SAS and SDS score scored were lower in than in the control group (P < 0.05). The PFDI-20, PFIQ-7 scores positively correlated with the SAS and SDS scores.

CONCLUSION

VSSLS demonstrated a significant effect on the treatment of moderate and severe POP, as it can reduce the prolapse distance and PFDI-20 and PFIQ-7 scores and improve anxiety and depression among patients.