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International Urogynecology Journal

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Open Access 01-01-2022 | Wound Infection | Review Article

Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis

Authors: Wenju Zhang, Willy Cecilia Cheon, Li Zhang, Xiaozhong Wang, Yuzhen Wei, Chaoxia Lyu

Published in: International Urogynecology Journal | Issue 1/2022

Abstract

Introduction and hypothesis

Sacrocolpopexy and sacrospinous ligament fixation (SSLF) have been used for the restoration of apical support. Studies comparing sacrocolpopexy and SSLF have reported conflicting results. We aim to assess the current evidence regarding efficiency and the complications of sacrocolpopexy compared with SSLF.

Methods

We searched PubMed, Embase, and Cochrane Library and performed a systematic review meta-analysis to assess the two surgical approaches.

Results

5Five randomized controlled trials, 8 retrospective studies, and 2 prospective studies including 4,120 cases were identified. Compared with abdominal sacrocolpopexy (ASC), SSLF was associated with a lower success rate (88.32% and 91.45%; OR 0.52; 95% CI 0.29–0.95; p = 0.03), higher recurrence (11.58% and 8.32%; OR 1.97; 95% CI 1.04–3.46; p = 0.04), and dyspareunia rate (14.36% and 4.67%; OR 3.10; 95% CI 1.28–7.50; p = 0.01). Patients in this group may benefit from shorter operative time (weighted mean difference −25.08 min; 95% CI −42.29 to −7.88; p = 0.004), lower hemorrhage rate (0.85% and 2.58%; OR 0.45; 95% CI 0.25–0.85; p = 0.009), wound infection rate (3.30% and 5.76%; OR 0.55; 95% CI 0.39–0.77; p = 0.0005), and fewer gastrointestinal complications (1.33% and 6.19%; OR 0.33; 95% CI 0.15–0.76; p = 0.009).

Conclusion

Both sacrocolpopexy and SSLF offer an efficient alternative to the restoration of apical support. When anatomical durability and sexual function is a priority, ASC may be the preferred option. When considering factors of mesh erosion, operative time, gastrointestinal complications, hemorrhage, and wound infections, SSLF may be the better option.

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Title: Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis
Authors: Wenju Zhang
Willy Cecilia Cheon
Li Zhang
Xiaozhong Wang
Yuzhen Wei
Chaoxia Lyu
Publication date: 01-01-2022
Publisher: Springer International Publishing
Keywords: Wound Infection
Cystocele
Dyspareunia
Cystocele
Sacrocolpopexy
Rectocele
Published in: International Urogynecology Journal / Issue 1/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-021-04823-w

At a glance: The STEP trials

Springer Medicine

Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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