Background: The aim of this study was to investigate patients having
pelvic organ prolapse (POP) stage 2 and greater who have undergone vaginal
hysterectomy concomitant with sacrospinous ligament fixation (VAH + SLF) or total
laparoscopic hysterectomy concomitant with sacrocolpopexy (TLH + SCP) in terms of
quality of life, sexual function, major or minor complications, and cure rates.
We also aimed to determine which procedure is superior according to the results
of the cases in which TLH + SCP and VAH + SLF were applied. Methods: A
retrospective cohort study was conducted at a tertiary center, including 137
patients who underwent vaginal or laparoscopic hysterectomy for symptomatic
uterine prolapse with a pelvic organ prolapse quantification system (POP-Q) score
2 and who underwent sacrospinous fixation (n = 90) or laparoscopic
sacrocolpopexy (n = 47) concomitantly between January 2017 and May 2022. The
Turkish-validated Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire
(PISQ-12) and the Prolapse Quality of Life Questionnaire (P-QoL) were asked to be
completed prior to surgery, on the 30th postoperative day, at six months, and at
one year. Results: There was no statistically significant difference
among groups regarding the scores of the PISQ-12 and P-QoL questionnaires. The
TLH + SCP group had a longer operative time (108 vs. 94 min, p
= 0.037). A statistically significant difference was found in blood loss between
the operations, favoring the TLH + SCP group (p = 0.038). Postoperative
6th-hour visual analog scale values were significantly higher in the TLH + SCP
group (p = 0.01). Two women (2.2%) in the VAH + SLF group had a
recurrence within one year postoperatively versus none in the TLH + SCP group
(p = 0.038). Conclusions: The TLH + SCP group had the same
decrease in subjective outcomes (PISQ-12 and P-QoL), whereas the VAH + SLF group
had a lower major complication rate than the TLH + SCP group. There is a need for
a prospective, multicenter, randomized controlled study with multiple patients
and long-term follow-up results to understand the ideal form of vaginal cuff
suspension following a hysterectomy.