Mid-term outcomes after colpocleisis versus sacrospinous ligament fixation: VIGI-MESH registry.

Abstract

<h4>Introduction</h4>The study aims to evaluate and compare severe complications and postoperative recurrence between women who underwent a colpocleisis and those who underwent a sacrospinous ligament fixation (SSF) for Pelvic Organ Prolapse (POP), based on data from the VIGI-MESH registry.<h4>Materials and methods</h4>A prospective, multicenter ancillary analysis of the VIGI-MESH registry from February 2017 to November 2022 compared colpocleisis and SSF surgeries. Women were matched 1:2 on BMI (±3kg/m²), American Society of Anesthesiologists (ASA) class, and history of genital prolapse surgery. Follow-up continued until March 2023, assessing serious complications (≥ Clavien-Dindo classification grade III) and POP recurrence requiring surgery using t-tests, chi-square tests, and Kaplan-Meier survival analysis.<h4>Results</h4>The study included 312 matched women: 104 in the colpocleisis group and 208 in the SSF group. Colpocleisis women were older (82.1 vs 71.0 years, p < 0.01) and less sexually active (1 % vs. 25.9 %, p < 0.01). The operative time was shorter for colpocleisis (65.8 min vs. 81.8 min, p < 0.01). Severe complications were slightly more common in the colpocleisis group but not statistically significantly different (2.8 % vs. 0.5 %, HR = 6.0, 95 % CI [0.6, 57.9], p = 0.08). Rates of prolapse recurrence requiring surgery were close (2.9 % for colpocleisis vs 4.3 % for SSF, HR = 0.6, 95 % CI [0.2, 2.3], p = 0.5). Time to recurrence surgery was longer in the colpocleisis group (916.9 days vs. 570.7 days, p < 0.01).<h4>Conclusion</h4>Colpocleisis and SSF showed effective management of POP comparable recurrence rates. Colpocleisis had shorter operative times and longer intervals before recurrence surgery, with a non-significant increase in severe complications.