LPP vs VSSF dataset
Background: Pelvic organ prolapse (POP) is a herniation of the pelvic organs that affects the quality of life of about half of all parous women. Vaginal sacrospinous fixation (VSSF) and laparoscopic pectopexy (LPP) are two common procedures in POP surgery. The aim was to compare the outcomes and patient satisfaction of women who underwent surgery using these two methods.
Methods: A prospective, randomized, single-center study was conducted with a total of 71 women with POP who underwent VSSF or LPP at a large reference hospital between January 01, 2019 and February 27, 2020. Preoperative prolapse stage, presence of urinary incontinence, demographic data, perioperative outcomes, and preoperative and postoperative scores on the Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), POP/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12), and Prolapse Quality of Life (P-QoL) were compared. Lower scores in the first three questionnaires and higher scores in the last questionnaire indicated better improvement.
Results: The study was completed with a total of 59 participants, 33 of whom underwent VSSF and 26 underwent LPP. Preoperative IIQ-7, UDI-6 and P-QoL scores improved significantly in both groups both 6 months and 3 years after surgery, while PISQ-12 scores showed a slight improvement. P-QoL scores were significantly lower in the VSSF group 6 months and 3 years postoperatively (p=0.009 and 0.001, respectively). At the 3rd year postoperative follow-up, the rates of de novo cystocele, rectocele, urge and stress urinary incontinence were extremely low and did not differ between the groups.
Conclusions: Both methods lead to significant improvement in all prolapse symptoms, although the improvement in quality of life is more pronounced with VSSF. In addition, LPP is a promising, safe, and effective minimally invasive surgical technique for prolapse reconstruction, while VSSF continues to consolidate its position in prolapse surgery along with the increasing importance of native tissue reconstruction.
