Perioperative complications and short-term outcomes of abdominal sacrocolpopexy, laparoscopic sacrocolpopexy, sacrospinous ligament fixation, and iliococcygeus fixation procedures

Abstract

Background/aim: This study aimed to investigate differences in perioperative complications and short-term outcomes of patientswho underwent abdominal sacrocolpopexy/sacrohysteropexy, laparoscopic sacrocolpopexy/sacrohysteropexy, sacrospinous ligamentfixation (SSLF), and iliococcygeus fixation due to apical prolapse.Materials and methods: The present retrospective cohort study included 145 patients who underwent apical prolapse surgeryperformed by the same surgeons between 1/1/2011 and 30/6/2017. There were 68 abdominal sacrocolpopexies (44 sacrocolpopexies and24 sacrohysteropexies), 13 laparoscopic sacrocolpopexies (10 sacrocolpopexies and 3 sacrohysteropexies), 57 SSLFs, and 7 iliococcygeusfixations. Patients’ short-term outcomes, perioperative complications, blood loss, operative time, and hospital stay were analyzed.Results: The mean operating time in the laparoscopic sacrocolpopexy group was 179.6 min versus 122.8, 117.3, and 107.1 min in theSSLF, abdominal sacrocolpopexy, and iliococcygeus fixation groups, respectively (P < 0.01). The hospital stay was significantly shorter inthe iliococcygeus fixation group (1.86 days) when compared with that of other groups (P < 0.01). During a 6-month follow-up period,no prolapse recurrence or mesh exposure was observed in any groups. Wound complications were more frequent in the abdominalsacrocolpopexy group. However, the overall complication rate of each group did not differ significantly (P = 0.332).Conclusion: Overall, complication rates and short-term outcomes for the abdominal, laparoscopic, and vaginal surgical procedureswere not statistically significantly different. However, minimally invasive approaches were associated with reduced procedural-relatedmorbidity.