International Urogynecology Journal最新文献

{"title":"Laparoscopic Meshless Lateral Suspension in Patients with Advanced Stage Pelvic Organ Prolapse. A Prospective Cohort Study with a Median 36-Month Follow-Up.","authors":"Cetin Kilicci, Resul Karakus, Reyyan Gokcen Iscan, Sultan Seren Karakus, Onder Tosun, Mine Guray Uzun, Turhan Aran","doi":"10.1007/s00192-025-06305-9","DOIUrl":"https://doi.org/10.1007/s00192-025-06305-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Laparoscopic lateral suspension with mesh is an effective technique for apical prolapse repair. In this study, we aimed to evaluate the outcomes of meshless laparoscopic lateral suspension in patients with advanced stage pelvic organ prolapse.</p><p><strong>Methods: </strong>This study was conducted prospectively on patients with apical defects who had stage 3 or greater pelvic organ prolapse. The cervix or vaginal cuff was below the hymen in all patients. POP-Q measurements were performed. Meshless laparoscopic suspension was performed with a nonabsorbable suture. Perioperative complications were also noted. The patients were followed up. Late postoperative results at 36 months were noted. Objective cure was defined as POP-Q stage < II in any compartment. Objective cure rate and pelvic organ prolapse quantification system score were the main outcome measures.</p><p><strong>Results: </strong>A total of 32 patients were included in the study. The mean age was 54.97 ± 13.31 years. Laparoscopic meshless suspension was performed in all patients under general anesthesia. Total laparoscopic hysterectomy was performed in 25 patients (78.1%). Other concomitant procedures were uterosacral ligament plication, laparoscopic cystocele repair, retropubic TVT, BURCH colposuspension, and posterior colporaphy. The median pelvic organ prolapse quantification score was significantly lower at 36 months postoperative. We calculated the objective cure rate for meshless laparoscopic lateral suspension for apical defects to be 81.3% at the 36-month follow-up.</p><p><strong>Conclusions: </strong>Laparoscopic meshless lateral suspension is a novel technique with promising initial results that require further evaluation.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Control Audit of Urodynamic Traces Published in Scientific Articles.","authors":"Juan Pablo Valdevenito, Mauricio Olea, Cristián Urrutia, Alejandro Mercado-Campero, Salvador Arlandis","doi":"10.1007/s00192-025-06359-9","DOIUrl":"https://doi.org/10.1007/s00192-025-06359-9","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The published urodynamic traces have been selected by their authors and subjected to peer review. The aims of the study were to describe quality control and print size of urodynamic traces published in scientific articles.</p><p><strong>Methods: </strong>All articles published during 5 years from four specialized journals were reviewed. Eighteen articles with filling cystometry and/or pressure-flow studies traces were selected for analysis. Urodynamic traces were classified according to the type of curve. The minimum acceptable print size was half the width of the page for filling cystometry and pressure-flow studies, and the full width of the page for filling cystometry + pressure-flow studies. Eleven items of the Bristol UTraQ scoring system were evaluated. Articles that explicitly stated that they had followed the ICS good urodynamic practices were recorded.</p><p><strong>Results: </strong>Four items had less than 50% compliance: intravesical and abdominal pressures marked on the trace as being zeroed to atmosphere, good quality cough test done at the end of filling, before voiding, \"permission to void\" indicated on the trace and good quality cough test done after the final void. There were no statistical differences in the quality control scores between articles that did and did not explicitly state that they had followed ICS good urodynamic practices. Twenty-one out of 44 traces (47.7%) had a minimum acceptable print size.</p><p><strong>Conclusion: </strong>Published urodynamic traces of these journals demonstrate imperfect quality control and have small print sizes. This generates the need to maintain vigorous strategies for disseminating and monitoring \"good urodynamic practices.\"</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of High-Intensity Focused Electromagnetic (HIFEM) Therapy in Women with Urinary Incontinence.","authors":"Apiwat Jongjakapan, Teerayut Temtanakitpaisan, Kamonphan Pinjaroen, Chompilas Chongsomchai, Amornrat Temtanakitpaisan","doi":"10.1007/s00192-025-06362-0","DOIUrl":"https://doi.org/10.1007/s00192-025-06362-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary incontinence (UI) affects the quality of life of millions of women. High-intensity focused electromagnetic (HIFEM) therapy is a promising noninvasive treatment, but robust evidence is limited. This study aimed to evaluate the effectiveness of HIFEM therapy in improving UI symptoms, quality of life, and sexual function in Thai women.</p><p><strong>Methods: </strong>This prospective single-arm interventional study enrolled women aged ≥ 20 years with an International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score ≥ 6. Women with pelvic organ prolapse stage > 2 or with contraindications to HIFEM therapy were excluded. Participants received six HIFEM sessions over 3 weeks. Outcomes, including the ICIQ-UI SF, Incontinence Impact Questionnaire (IIQ-7), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-IUGA Revised (PISQ-IR), were assessed at baseline, post-treatment, and 3-month follow-up. Generalised estimating equations, mean/median difference (MD) with 95% confidence intervals (CI), were used for statistical analysis.</p><p><strong>Results: </strong>Fifty-seven women completed the protocol. UI types were stress UI (43.9%), mixed UI (42.1%), and urgency UI (14.0%). Median ICIQ-UI SF significantly decreased at post-treatment (MD -5.21; 95% CI -6.23 to -4.19) and 3 months (MD -5.04; 95% CI -6.13 to -3.94; p < 0.001). IIQ-7 scores improved similarly. Among sexually active women, improvements were noted in arousal/orgasm, and condition impact subscales of PISQ-IR. No significant changes were found in non-sexually active women.</p><p><strong>Conclusions: </strong>HIFEM therapy significantly improved UI symptoms, quality of life, and some aspects of sexual function. Larger comparative trials with long-term follow-up are needed before routine clinical use is recommended.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Evaluation of Double Versus Loop Suture Techniques in Sacrospinous Ligament Fixation Over Two Years.","authors":"Ayşe Betül Albayrak Denizli, Eralp Bulutlar, Gizem Berfin Uluutku Bulutlar, Gizem Boz İzceyhan, Sadık Şahin","doi":"10.1007/s00192-025-06341-5","DOIUrl":"10.1007/s00192-025-06341-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Sacrospinous ligament fixation (SSF) is a widely accepted native tissue technique for apical pelvic organ prolapse (POP), especially following the decline in mesh-based procedures. However, the optimal suture technique remains under debate.</p><p><strong>Objectives: </strong>To compare the clinical outcomes of double versus loop suture techniques in SSF, with a focus on operative efficiency, complications, recurrence, and reoperation rates over a 24-month follow-up.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included 195 patients with stage 3 or 4 POP who underwent SSF with nonabsorbable polypropylene suture between January 2020 and January 2023 in a tertiary-care academic hospital specializing in urogynecologic surgery. Group 1 (n = 115) underwent classical double suture SSF, while group 2 (n = 80) received the loop suture technique. Demographic characteristics, operative times, perioperative complications, recurrence, and reoperation rates were recorded and compared between the groups.</p><p><strong>Main outcome measures: </strong>Primary outcomes were total operative time. Secondary outcomes included postoperative complications such as gluteal pain, recurrence rate, and reoperation rate.</p><p><strong>Results: </strong>Both groups were similar in age, BMI, and baseline POP stage. The loop suture group had significantly shorter total operative time (154.04 ± 41.83 vs. 112.85 ± 37.34 min, p < 0.001) and SSF-specific surgical time (59.09 ± 22.97 vs. 37.34 ± 10.91 min, p < 0.001). Although recurrence rates were similar (24.3% in the double suture group vs. 18.7% in the loop suture group, p = 0.452), reoperation was significantly less frequent in the loop group (5% vs. 14.7%, p = 0.035). Gluteal pain occurred more often in the double suture group, although these differences were not statistically significant.</p><p><strong>Conclusion: </strong>The loop suture technique appears to be a safe and efficient alternative to the classical double suture method for SSF, offering reduced operative time and lower reoperation rates without compromising effectiveness.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Significance of Type A Botulinum Toxin Ten-Point Injection Therapy in the Treatment of Chronic Pelvic Pain Caused by Muscle Spasms in Women.","authors":"Jin Yang, Xian Ma, Cheng Luo, Jiaqi Zhang, Cancan Wang, Haiou Yang, XinPing Zhang, Yonghui Guan","doi":"10.1007/s00192-025-06346-0","DOIUrl":"https://doi.org/10.1007/s00192-025-06346-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>This study aims to evaluate the efficacy, safety, and socioeconomic impact of botulinum toxin type A trigger point injection therapy and ten-point injection therapy for chronic pelvic pain syndrome (CPPS) caused by muscle spasm, while also exploring the efficacy and clinical significance of botulinum toxin type A ten-point injection therapy in the treatment of chronic pelvic pain.</p><p><strong>Methods: </strong>This study conducted a retrospective analysis of patients hospitalized at a tertiary hospital from January 2024 to December 2024 who were diagnosed with chronic pelvic pain syndrome (CPPS) caused by pelvic floor muscle spasm. On the basis of the treatment protocol, these patients were divided into the trigger point pelvic floor muscle injection group and the ten-point injection therapy group, with data collected through follow-up visits or telephone interviews. The baseline characteristics of the two groups were compared, including age, body mass index (BMI), pain intensity (assessed using the Facial Pain Scale-Revised [FPS-R]), Short Form 12 Health Survey (SF-12), Hamilton Anxiety Rating Scale (HARS), and Overactive Bladder Symptom Score (OABSS). Propensity score matching (PSM) was used to balance significant differences in general characteristics between the two groups at a 1:1 ratio. Among the 91 patients, 44 received trigger point pelvic floor muscle injection therapy, and 47 received ten-point injection therapy. PSM successfully matched 64 patients, with 32 in each group.</p><p><strong>Results: </strong>Among the 91 patients, 64 were successfully matched using the PSM method, divided into two groups of 32 patients each. The baseline characteristics of the patients in each group were well matched, with all showing (P > 0.05). Postoperative follow-up data indicated that both groups of patients showed a synchronous improvement trend in pain relief, anxiety improvement, and quality of life enhancement, with no statistically significant differences at any time point. This suggests that both injection methods have similar efficacy in improving clinical symptoms and quality of life in patients with chronic pelvic pain caused by muscle spasm.</p><p><strong>Conclusion: </strong>Both the ten-point injection method and trigger point injection method using type A botulinum toxin demonstrate comparable safety and efficacy in treating chronic pelvic pain caused by pelvic floor muscle spasm. However, the ten-point injection method has significant advantages in terms of not relying on trigger point localization, having a relatively fixed operational process, a shorter learning curve, less time-consuming procedures, and causing less discomfort to patients, which supports its broader clinical application.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress Urinary Incontinence Procedure Outcomes in the < 40-Year-Old Population: A Multicenter Study.","authors":"Ashley Huber, Hoa Nguyen, Nicole Meckes, Sujatha Narayanamoorthy, Lauren Tholemeier, Ravi Patel, Gabriella Rustia, Margot Le Neveu, Madeline Coulter, Alexander DelVlahos, Zachary Selzler, Nicholas Scioscia, Trieu Do, Jared Floch, K Marie Douglass, Lisbet Lundsberg, Nancy Ringel","doi":"10.1007/s00192-025-06289-6","DOIUrl":"https://doi.org/10.1007/s00192-025-06289-6","url":null,"abstract":"<p><strong>Objectives: </strong>Stress urinary incontinence (SUI) is a common problem affecting the quality of life of many women, but treatment outcomes in younger women are sparsely reported. We sought to evaluate SUI procedure outcomes in women < 40 years old.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study of women < 40 years old who underwent a primary SUI procedure between January 1, 2020 and July 1, 2023. We compared outcomes and complication rates of midurethral slings to periurethral bulking with polyacrylamide hydrogel (PAHG). Data was extracted by manual chart review and analyzed using descriptive statistics, comparative statistics with chi-square or Fisher exact tests, or the Wilcoxon two sample test for continuous measurements. The primary outcome was report of cure or improvement in SUI symptoms.</p><p><strong>Results: </strong>Fifteen study sites were included, with individual IRB approvals obtained at each site. A total of 377 women < 40 years old were identified who underwent a primary SUI procedure during the study period; 40 underwent periurethral bulking with PAHG and 337 underwent sling (307 (91%) retropubic, 13 (4%) transobturator, 17 (5%) single incision). Baseline demographics were similar between groups. Reported rates for cure or improved symptoms were 88.6% (n = 31/35) for PAHG and 97.8% (n = 315/324) for slings (p = 0.0156) at 4 weeks and 81.8% (n = 9/11) for PAGH and 92.9% (n = 66/71) for slings at approximately 1 year postoperative (p = 0.131). Complication rates were low in both groups.</p><p><strong>Conclusions: </strong>Women < 40 years old who received periurethral bulking with PAHG for treatment of SUI had lower rates of cure/improvement at short-term follow-up in their SUI compared to those who received a sling.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"A Comparative Evaluation of Double Versus Loop Suture Techniques in Sacrospinous Ligament Fixation Over Two Years\".","authors":"Andre Plair","doi":"10.1007/s00192-025-06347-z","DOIUrl":"10.1007/s00192-025-06347-z","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Oral Mirabegron on Catheter-Related Bladder Dysfunction After Elective Gynecological Surgery Under General Anesthesia: A Randomized, Placebo-Controlled, Double-Blind Study.","authors":"Alok Kumar Sahoo, Sweta Singh, Jasmina Begum, Chandra Jyoti, Satyajeet Misra","doi":"10.1007/s00192-025-06300-0","DOIUrl":"https://doi.org/10.1007/s00192-025-06300-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Mirabegron, an oral β-3 adrenoreceptor agonist, is used to treat overactive bladder symptoms. We investigated the effect of preoperative oral mirabegron on postoperative catheter-related bladder dysfunction (CRBD) in elective gynecological surgeries.</p><p><strong>Methods: </strong>Eighty-eight women aged 18-65 years with American Society of Anesthesiologists physical status I-III were randomly assigned to receive either oral mirabegron (50-mg tablets) or a placebo 24 h and 1 h before surgery. The primary objective was the difference in the incidence of CRBD on a four-point scale at 1 h. Secondary objectives included differences in CRBD incidence at 0 h, 2 h, and 6 h; severity of CRBD at all time points; postoperative pain; analgesic usage; patient satisfaction; and adverse events.</p><p><strong>Results: </strong>The mirabegron group had a significantly lower incidence of CRBD (grades 2-4) at 1 h (43.2% vs 72.7%; p 0.009). CRBD incidence was also lower at 0 h (34.1% vs 61.4%; p 0.01) and 2 h (45.5% vs 75%; p 0.005), but comparable at 6 h. Severity of CRBD (grades 3-4) was lower in the mirabegron group at 1 h (6.8% vs 22.7%; p 0.035) and 2 h (0% vs 13.6%; p 0.04), but comparable at 0 h and 6 h. Rescue tramadol was lower in the mirabegron group (p 0.04). Mirabegron did not cause any significant adverse effects such as tachycardia or hypertension. There were no differences in other secondary outcomes.</p><p><strong>Conclusions: </strong>Two doses of oral mirabegron 50-mg tablets administered 24 h and 1 h before elective gynecological surgery reduced the incidence and severity of early CRBD.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptomatic Pelvic Floor Disorders and Their Associated Factors Among Women in Yilmana Densa Woreda, Northwest Ethiopia.","authors":"Kassahun Alamrew, Zelalem Mengistu, Anemaw Asrat","doi":"10.1007/s00192-025-06351-3","DOIUrl":"https://doi.org/10.1007/s00192-025-06351-3","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic floor disorders (PFDs) are common conditions affecting millions of women worldwide. In some regions of Ethiopia, research indicates that one in five women experience PFDs. However, this figure may underestimate the true prevalence due to the stigma surrounding these issues and limited access to healthcare. This study aimed to determine the prevalence of symptomatic PFDs and associated factors among women in Yilmana Densa Woreda.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted among 597 women in Yilama Densa Woreda, Northwest Ethiopia, using a multi-stage sampling technique. Data were collected using a structured, interviewer-administered questionnaire. Data are described, and the results are presented in tables and figures. Logistic regression analyses were performed to assess the predictors of symptomatic PFDs, with a significance level set at p < 0.05.</p><p><strong>Results: </strong>The prevalence of symptomatic pelvic floor disorders was 70%. Multivariable logistic regression analyses showed that advancing age [AOR 1.24, 95% CI (1.1, 1.3)], lack of formal schooling [AOR 2.64, 95% CI (1.3, 5.0)], carrying loads over 25 kg [AOR 9.82, 95% CI (5.2, 18.2)], and carrying loads for more than 5 h a day [AOR 3.82, 95% CI (2.0, 7.2)] were significantly associated with symptomatic pelvic floor disorders.</p><p><strong>Conclusions: </strong>This study found a very high prevalence of symptomatic PFDs. Factors such as increasing age, lack of formal education, heavy weightlifting, and caring for a prolonged duration daily were identified as potential associated factors. The findings highlight the need for education on PFDs and reducing workload, particularly for less educated women.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pull-Out Strength of Laparoscopic Sacrohysteropexy and Vaginal Sacrospinous Ligament Fixation in a Cadaver Model.","authors":"Tsia-Shu Lo, Louiza Erika Rellora, Eyal Rom, Wu-Chiao Hsieh, Chia-Hsuan Yang, Ai-Leen Ro","doi":"10.1007/s00192-025-06298-5","DOIUrl":"https://doi.org/10.1007/s00192-025-06298-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective was to determine the biomechanical strength of laparoscopic sacrohysteropexy (LSH) and sacrospinous ligament fixation (SSLF) by evaluating their pull-out forces.</p><p><strong>Methods: </strong>This study was conducted during a cadaver workshop in Taiwan, which allowed the participants to perform multiple vaginal and abdominal procedures for pelvic organ prolapse. The study focused on biochemical strength assessment of LSH and SSLF. Six fresh cadavers underwent LSH or SSLF using various anchoring techniques. LSH procedures used sutures and tackers to fixate to the sacral promontory or uterus, whereas SSLF was performed using the tackers only. A digital crane scale was used to measure pull-out strength for each procedure. Results recorded the maximum load at failure.</p><p><strong>Results: </strong>The SSLF procedure provided stronger apical support than LSH, with pull-out forces ranging from 25.3 to 52.5 N compared with LSH promontory fixation, which ranged from 12.6 to 13.7 N. Tackers used in SSLF showed consistent load bearing across all samples (44-47 N), whereas LSH grip strength varied with stitch numbers and anatomical positioning on the sacral promontory, with an average of 12.6 N. Vaginal load values are relatively consistent, with an average of 42.6 N across all cadavers. The instructor's initial attempt consistently demonstrated the highest strength, emphasizing the impact of the technique.</p><p><strong>Conclusions: </strong>The SSLF procedure provided superior apical support to LSH, suggesting that it might be preferable for managing POP. Variations in ligament condition affected outcomes, but SSLF provided more reliable support. A need for further research in live subjects is needed to verify the optimal anchoring approach in POP repair.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}