Safety and Efficacy of Minimally Invasive Sacrospinous Ligament Fixation for Apical Pelvic Organ Prolapse in Older Women

Background: This study aimed to evaluate the safety and efficacy of minimally invasive sacrospinous ligament (SSL) fixation of apical pelvic organ prolapse (POP) in older patients compared to younger patients. Methods: A cohort of 271 older (>= 65 years) patients (mean age 71.8 +/- 5.2 years) and 60 younger patients (mean age 47.6 +/- 7.1 years) with stage III or IV apical POP who underwent SSL fixation by the EnPlace (R) device was retrospectively analyzed. The age range of older patients was further divided into early old (65-74 y, N = 209), old (75-84 y, N = 58), and late old (>85 y, N = 4). Patient characteristics, surgical safety, and 6-month postoperative outcomes were compared between the four age groups. Results: Duration of surgery and blood loss were similar among all age groups. Most patients (99.4%) were discharged on the day of surgery or the day after. Subjective patient satisfaction rates were high among all patients. Point C measurements at six months postoperatively were less favorable among the younger patients. Furthermore, four (6.7%) younger patients versus six (2.2%) older patients required surgical repair of recurrent apical POP within the follow-up period. Conclusions: The short-term outcomes of minimally invasive SSL fixation suggest that it is a safe and effective procedure for significant apical POP repair among older patients.