Safety and feasibility analysis of transvaginal extraperitoneal space anatomical sacrospinous ligament suspension in the treatment of moderate to severe pelvic organ prolapse: a retrospective comparative cohort study.

BACKGROUND: Sacrospinous ligament fixation has become one of the important surgical procedures for treating pelvic organ prolapse. The traditional vaginal sacrospinous ligament fixation determines the suspension site through digital rectal examination, which carries a higher risk of intraoperative nerve injury and hemorrhage. This article aims to introduce the transvaginal extraperitoneal space anatomical sacrospinous ligament fixation and compare it with the traditional vaginal sacrospinous ligament fixation. A total of 40 patients were included in this study, and all patients were divided into the TEASLF group (n = 20) and the TSSLF group (n = 20) according to the principle of voluntary choice. MATERIALS AND METHODS: This article proposes the transvaginal extraperitoneal space anatomical sacrospinous ligament fixation, combining the advantages of precise endoscopic treatment with sacrospinous ligament fixation, and retrospectively analyzes the clinical data of 40 patients to evaluate this procedure. RESULTS: The treatment effects of the two groups were comparable. The intraoperative hemorrhage volume in this procedure was significantly reduced compared to the traditional group, but the operation time was slightly longer than that of the traditional group. There were no statistically significant differences between the two groups in postoperative hospital stay, postoperative ventilation time, catheter removal time, improvement in POPQ scores, and improvement in PFIQ-7 and PFDI-20 scores. CONCLUSION: Transvaginal extraperitoneal space anatomical sacrospinous ligament fixation is safe and effective for treating pelvic organ prolapse. This procedure provides better exposure of the surgical field, allows suturing under direct vision, helps avoid vascular and neuronal injury, and enables faster and more convenient hemostasis. This procedure also aids junior physicians in understanding the anatomy of the sacrospinous ligament, facilitating clinical teaching and technical promotion.