For a study, researchers sought to evaluate the efficiency and safety of uterosacral ligament suspension (ULS) and sacrospinous ligament fixation (SSLF) for surgical treatment of pelvic organ prolapse (POP).

Comparative studies have been found in, PubMed, EMBASE, MEDLINE, Cochrane Library, and Medicine databases. The investigations comprised prospective and retrospective cohort studies and randomized controlled trials. Anatomical success rate (defined as anterior or posterior vaginal wall beyond the hymen), surgical success rate, recurrence, and total complication rate were recorded as primary outcomes. Specific problem rates were gathered as secondary outcomes. Revman was used to examine the data.

A total of 57 publications had reached the screening stage after database searches and removing duplicate research. Finally, 4,516 subjects from 9 moderate and high-quality studies—4 randomized controlled trials and five retrospective studies—were included. There was no statistically significant difference between the two groups for the primary outcomes of surgical success rate (RR=1.00; 95% CI: 0.91-1.01; I2=0%; P=.98), anatomical success (RR=0.90; 95% CI: 0.78-1.05; I2=61%; P=.19), recurrence rate (RR=1.26; 95% CI: 0.85-1.87; I2=75%; P=.24) and total complication rate (RR=1.07; 95% CI: 0.89-1.28; I2=33%; P=.47). Similar findings in primary outcomes were reported in subgroup analyses using various follow-up durations (1, 2, and 5 years) and stages (Stage 2 and stage 3-4).

As a result, both SSLF and ULS were equally effective and secure for patients. However, because of its quick recovery time and straightforward procedure, SSLF was increasingly preferred by surgeons. In addition, it appeared to have fewer complications for vaginal granulation tissue and urethral damage. More high-quality research was still required, particularly with regard to the frequency of problems.