SACROSPINOUS LIGAMENT FIXATION VERSUS POSTERIOR INTRAVAGINAL SLINGPLASTY FOR APICAL PELVIC ORGAN PROLAPSE: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Fethiye ŞAHİN, Hüsnü ÇELİK

Annals of Clinical and Analytical Medicine - 2026;17(6):599-604

Department of Obstetrics and Gynecology, Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye

 

Aim: To compare the short-term anatomical and functional outcomes of sacrospinous ligament fixation (SSLF) and posterior intravaginal slingplasty (PIVS) in women with apical pelvic organ prolapse (POP). Methods: This single-center, prospective randomized controlled trial was conducted at Fırat University Faculty of Medicine between September 2007 and October 2008. Forty women with stage II or higher apical POP were randomized to undergo SSLF (n = 20) or PIVS (n = 20). The primary outcome was anatomical success at six weeks, defined as POP-Q stage < II. Secondary outcomes included operative time, blood loss, perioperative complications, postoperative pain (VAS), hospital stay, quality-of-life and sexual function scores (PFDI-20, PFIQ-7, PISQ-12, PQoL), and patient satisfaction. Statistical analysis was performed using Student's t, Mann-Whitney U, and chi-square tests, with p<0.05 considered significant. Results: Baseline characteristics were comparable between groups. PIVS was associated with a shorter mean hospital stay (2.6 vs. 3.7 days, p=0.004) and lower postoperative pain scores (2.9 vs. 4.3, p=0.001). At six weeks, anatomical success was achieved in 80% of SSLF and 85% of PIVS patients (p=0.71). Functional outcomes and patient satisfaction were comparable, and no early mesh erosion was observed. Conclusion: Both SSLF and PIVS provided effective short-term correction of apical prolapse. Considering its mesh-free design and favorable safety profile, SSLF remains the preferred native-tissue vaginal approach. Longer-term studies are warranted to confirm durability and comparative outcomes.