Peer-reviewed veterinary case report
Long-term outcomes of bilateral sacrospinous ligament fixation surgery
By Ubertazzi E et al.·2026·Hospital Italiano de Buenos Aires·View original on Europe PMC →
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Original publication title: A Retrospective Cohort Study of Bilateral Sacrospinous Ligament Fixation Over a Decade of Clinical Experience.
Plain-English summary
This study looked at a surgical procedure called bilateral sacrospinous ligament fixation (BSSLF), which is used to repair certain types of pelvic organ prolapse. Researchers followed 391 patients over a decade to see how well the procedure worked, especially when it was done without removing the uterus (total hysterectomy). They found that 94.3% of patients who had the procedure without a hysterectomy were cured, while those who had other surgical methods had a lower success rate of 83.2%. The study also noted that not doing a specific additional procedure (anterior colporrhaphy) increased the chances of treatment failure. Overall, the BSSLF procedure was very effective in the long term, especially when performed without a hysterectomy.
Abstract
<h4>Introduction and hypothesis</h4>Bilateral sacrospinous ligament fixation (BSSLF) is a well-established procedure for apical prolapse repair, yet surgical approaches and outcomes vary. This study presents the first large-cohort, long-term retrospective evaluation of BSSLF using the sling-like mesh Splentis®. We analyse anterior BSSLF (ABSSLF) outcomes without total hysterectomy and compare them with other surgical approaches used in clinical practice.<h4>Methods</h4>A total of 391 patients treated with Splentis between 2012 and 2023 at two referral centres were stratified into group A (ABSSLF without total hysterectomy, n = 248) and group B (other approaches including posterior fixation and/or total hysterectomy, n = 143). Outcomes were evaluated at intermediate (1-3 years, n = 256) and long-term follow-up (> 3 years, n = 135). Primary endpoint was composite cure: Pelvic Organ Prolapse Quantification (POP-Q) point C < 0, absence of bulge symptoms and no retreatment. Secondary endpoints included POP-Q changes, patient-reported symptoms and complications.<h4>Results</h4>Overall cure was 90.3% (95% CI 86.9-93.0%): group A, 94.3% (95% CI 90.7-96.9%); group B, 83.2% (95% CI 76.1-88.9%). Group A remained stable at long-term follow-up, whereas group B declined by 16.2 percentage points. Omission of concomitant anterior colporrhaphy was associated with higher odds of treatment failure (OR 3.0, 95% CI 1.3-6.8; p = 0.010). Most complications were Clavien-Dindo ≤ II. Mesh-related complications were 4.8% (95% CI 2.5-8.3%) in group A and 5.6% (95% CI 2.4-10.7%) in group B.<h4>Conclusions</h4>The ABSSLF procedure using Splentis showed high long-term effectiveness when used for hysteropexy or cervicopexy, that is, without prior/concomitant total hysterectomy. Other approaches showed lower yet favourable outcomes, highlighting the versatility of the device and the importance of patient selection.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/42059946