title: Medium-term outcomes of laparoscopic sacrocolpopexy or sacrohysteropexy versus vaginal sacrospinous ligament fixation for middle compartment prolapse.
abstract: OBJECTIVE
  To compare laparoscopic sacrocolpopexy (LSC) or sacrohysteropexy (LSH) with vaginal sacrospinous ligament fixation (VSSLF) for middle compartment pelvic organ prolapse (POP).
  
  
  METHODS
  Data were retrospectively reviewed from patients with POP (stage 3 or worse) who underwent LSC, LSH, or VSSLF at a center in Shanghai between January 2009 and March 2014. POP quantification (POP-Q) and Pelvic Floor Distress Inventory scores were compared at the 2-year follow-up.
  
  
  RESULTS
  Data were available for the 2-year follow-up for 102 LSC, 11 LSH, and 94 VSSLF procedures. Compared with patients who had undergone VSSLF, those who had undergone LSC/LSH had better POP-Q C values (P<0.001), longer total vaginal length (TVL) (P<0.001), and lower Aa and Ba scores (P=0.003 and P=0.002, respectively). Apical compartment and overall success rates of LSC/LSH and VSSLF did not differ significantly. Quality of life was improved in both groups (P<0.001). Both groups achieved symptomatic relief, although bowel and urinary functions were significantly improved only in the VSSLF group (P<0.001 for both). More patients in the LSC/LSH group were sexually active at 2 years (P<0.001); improvement in sex life was similar between the groups.
  
  
  CONCLUSIONS
  Although LSC/LSH achieved longer TVL, both groups achieved the same success rate and improvement in quality of life. Specifically, VSSLF yielded a significant improvement in bowel and urinary function.
authors.affiliation: Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
authors.forename: Yisong
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
authors.forename: Keqin
authors.initials: K
authors.lastname: Hua
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications; D012445:Sacrococcygeal Region; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery; D016387:Women's Health
keywords: Laparoscopic; Sacrocolpopexy; Sacrohysteropexy; Sacrospinous ligament fixation; Uterine and vaginal vault prolapse