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Review
. 2022 Dec;33(12):3519-3527.
doi: 10.1007/s00192-022-05092-x. Epub 2022 Feb 28.

Anterior bilateral sacrospinous ligament fixation with concomitant anterior native tissue repair: a pilot study

Charlotte Delacroix  1 , Lucie Allegre  2 , Kyriaki Chatziioannidou  2   3 , Armance Gérard  2 , Brigitte Fatton  2 , Renaud de Tayrac  2
Affiliations
Review

Anterior bilateral sacrospinous ligament fixation with concomitant anterior native tissue repair: a pilot study

Charlotte Delacroix et al. Int Urogynecol J. 2022 Dec.

Abstract

Introduction and hypothesis: Anterior bilateral sacrospinous ligament fixation (ABSSLF) was first described in 2000 but only evaluated in a limited number of studies. However, due to the FDA's ban on transvaginal mesh, interest in this technique has re-emerged. The SSLF procedure is known for its inherent high risk for anterior compartment failure; hence, in our center we started performing a preemptive concomitant anterior repair with the intention to reduce such risk. The aim of this study was to review the feasibility and clinical outcomes of this innovative technique.

Methods: We performed a retrospective cohort study of all the women who had an ABSSLF and a concomitant anterior native tissue repair between May 2019 and July 2020 in a tertiary hospital in France. Our primary endpoint was surgical feasibility, while as secondary endpoints we wanted to explore the perioperative morbidities and clinical outcomes associated with this technique.

Results: A total of 50 women were operated on in the studied period. The median follow-up time was 10 [8.5] months. It was feasible to perform the combined ABSSLF and concomitant anterior native tissue repair in all cases. The most frequent perioperative complications reported were urinary tract infection (14%) and difficulty in resuming voiding (16%). Anatomical and functional results were improved. The rate of anterior compartment recurrence was 37%.

Conclusions: ABSSLF with a concomitant anterior native tissue repair is feasible and relatively safe for treating anterior and apical pelvic prolapse. However, anterior compartment failure rate is still a limitation. Further larger studies with long-term anatomical and functional results comparing this technique to alternative transvaginal surgical approaches are needed.

Keywords: Anterior approach; Bilateral sacrospinous ligament fixation (BSSLF); Native tissue repair; Pelvic organ prolapse; Uterosacral ligament suspension; Vaginal prolapse repair.

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Conflict of interest statement

Prof. De Tayrac and Dr. Fatton are consultants for Boston Scientific; remaining authors claim no conflict of interest.

Figures

Fig. 1
Fig. 1
Surgical technique
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References

    1. Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J. Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev. 2016;11:CD004014. - PMC - PubMed
    1. Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in US women: 2010 to 2050. Obstet Gynecol. 2009;114(6):1278–1283. doi: 10.1097/AOG.0b013e3181c2ce96. - DOI - PubMed
    1. Lua LL, Vicente ED, Pathak P, Lybbert D, Dandolu V. Comparative analysis of overall cost and rate of healthcare utilization among apical prolapse procedures. Int Urogynecol J. 2017;28(10):1481–1488. doi: 10.1007/s00192-017-3324-5. - DOI - PubMed
    1. FDA Public Health Notification (Medical Devices): Urogynecologic Surgical Mesh Implants. 2019. http://www.fda.gov/medical-devices/implants-and-prosthetics/urogynecolog.... Accessed 17 June 2019.
    1. Ouzaid I, Ben Rhouma S, de Tayrac R, Costa P, Prudhomme M, Delmas V. Sacrospinofixation mini-invasive avec le dispositif CAPIO : étude anatomique [Mini-invasive posterior sacrospinous ligament fixation using the CAPIO needle driver: an anatomical study]. Prog Urol. 2010;20(7):515–9. French. - PubMed