Laparoscopic uterosacral ligament suspension versus sacrospinous ligament fixation for apical prolapse: Perioperative outcomes

Martina G. Gabra, Veronica Winget, Mohammad T. Torabi, Ilana Addis, Kenneth Hatch, John Heusinkveld

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Pelvic organ prolapse can be repaired vaginally or laparoscopically. Studies comparing vaginal repair with sacrospinous ligament fixation (SSLF) or uterosacral ligament suspension (V-USLS) have found no difference in functional or adverse outcomes. Laparoscopic USLS (L-USLS) is becoming a popular treatment for pelvic organ prolapse because it has a low rate of ureteral compromise. To date, no studies have compared perioperative outcomes between L-USLS and SSLF. The objective of this study is to compare the rates of perioperative complications between these two methods. Methods: This was a retrospective chart review of 243 consecutive patients who underwent L-USLS or SSLF at one institution between March 2017 and August 2019 for apical pelvic organ prolapse. Descriptive data was analyzed as appropriate with Student’s t tests and chi-square. Univariable logistic regression analysis was performed to assess predictors of perioperative complications. Results: Preoperative Pelvic Organ Prolapse Quantification Stage (POP-Q) was similar between the two cohorts (p = 0.23). After adjusting for confounding factors, L-USLS was associated with a longer operative time (118 vs 142 min, p < 0.01) and shorter length of hospitalization (0.68 vs 1.06 days, p < 0.01). The estimated blood loss between the procedures was not statistically significant after adjusting for confounding factors. There was no difference in perioperative complication rates between L-USLS and SSLF (5% vs 7%, p = 0.55). No clinical risk factors were significantly associated with perioperative complications. Conclusion: We did not find a difference in complications between L-USLS and SSLF.

Original languageEnglish (US)
Article number15
JournalGynecological Surgery
Issue number1
StatePublished - Dec 2021


  • Laparoscopic uterosacral ligament suspension
  • Perioperative complications
  • Sacrospinous ligament fixation

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology


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