Anatomical outcomes of laparoscopic high uterosacral ligament suspension for primary apical prolapse

Abstract

Objective: We aimed to evaluate the short-term anatomical results of laparoscopic high uterosacral ligament suspension (LHUSLS) in the surgical treatment of apical prolapse. Materials and Methods: Medical records of thirty women with stage 2 or higher cuff or uterine apical prolapse who underwent LHUSLS operations were retrospectively analysed. Preoperative, intraoperative, and 6-and 12-month short-term postoperative data were recorded. Anatomical success was defined as no prolapse for any Pelvic Organ Prolapse Quantification (POP-Q) point at or below 1 cm above the hymen. To evaluate prolapse symptoms, we used the Pelvic Organ Prolapse Distress Inventory (POPDI)-6 questionnaire. Results: Based on stage II of POP-Q as the recurrence criteria, the anatomical success rate was 100%. The POP-Q point C, Aa, Ap, Ba and Bp measurements were significantly higher after surgery than the preoperative values. There was no recurrence or ureteral injury in any case. The scores of POPDI-6 before and after LHUSLS were significantly lower in all patients after surgery (p<0.001). Conclusion: LHUSLS is a simple and effective procedure that has been found to provide successful anatomical outcomes and reduced ureteral injury for apical prolapse. However, the long-term results of this procedure require further investigation.