Comparison of Postoperative Functional Recovery and Anatomical Restoration in Patients with Pelvic Organ Prolapse Undergoing Three Types of Apical Suspension Techniques: A Retrospective Study.

INTRODUCTION AND HYPOTHESIS: Surgery is a key treatment for pelvic organ prolapse (POP). This study was aimed at comparing the effects of sacrospinous ligament fixation (SSLF), laparoscopic lateral suspension (LLS), and extraperitoneal high uterosacral ligament suspension (EHUS) on anatomical restoration and functional recovery in patients with POP. METHODS: This retrospective cohort study included 188 patients with POP who underwent SSLF, LLS, or EHUS between 2020 and 2023. Baseline characteristics, Pelvic Organ Prolapse Quantification (POP-Q), lower urinary tract symptoms, and questionnaire scores were collected preoperatively, and at 1 and 12 months postoperatively. The primary outcome was surgical success; secondary outcomes included POP-Q scores and patient-reported symptom improvement. RESULTS: Preoperative data were comparable among the three groups (p > 0.05). The surgical success rates were 84.93% (62 out of 73) for SSLF, 85.00% (34 out of 40) for LLS, and 77.78% (35 out of 45) for EHUS, with no significant difference. Anatomical success rates were 95.89% for SSLF, 95.00% for LLS, and 84.44% for EHUS. SSLF demonstrated a significantly higher anatomical success rate than EHUS (p = 0.012). Subjective cure rates were 84.93%, 90.00%, and 84.00%, and satisfaction rates were 94.52%, 95.0%, and 93.33% for SSLF, LLS, and EHUS groups respectively. All groups showed significant postoperative improvements in POP-Q and questionnaire scores. The SSLF group exhibited a significantly greater reduction in questionnaire scores from baseline to 12 months than the EHUS group (p < 0.05). CONCLUSION: At 12 months postoperatively, no single technique (SSLF, LLS, or EHUS) demonstrated overall superiority in surgical success. SSLF was associated with superior anatomical outcomes and greater symptom improvement than EHUS.