Safety and Efficacy of Minimally Invasive Sacrospinous Ligament Fixation for Apical Pelvic Organ Prolapse in Older Women.

Abstract

<b>Background:</b> This study aimed to evaluate the safety and efficacy of minimally invasive sacrospinous ligament (SSL) fixation of apical pelvic organ prolapse (POP) in older patients compared to younger patients. <b>Methods:</b> A cohort of 271 older (≥65 years) patients (mean age 71.8 ± 5.2 years) and 60 younger patients (mean age 47.6 ± 7.1 years) with stage III or IV apical POP who underwent SSL fixation by the EnPlace^® device was retrospectively analyzed. The age range of older patients was further divided into early old (65-74 y, N = 209), old (75-84 y, N = 58), and late old (>85 y, N = 4). Patient characteristics, surgical safety, and 6-month postoperative outcomes were compared between the four age groups. <b>Results:</b> Duration of surgery and blood loss were similar among all age groups. Most patients (99.4%) were discharged on the day of surgery or the day after. Subjective patient satisfaction rates were high among all patients. Point C measurements at six months postoperatively were less favorable among the younger patients. Furthermore, four (6.7%) younger patients versus six (2.2%) older patients required surgical repair of recurrent apical POP within the follow-up period. <b>Conclusions:</b> The short-term outcomes of minimally invasive SSL fixation suggest that it is a safe and effective procedure for significant apical POP repair among older patients.