The safety and effectiveness of laparoscopic anterior sacral ligament suspension combined with dome suspension in the treatment of bladder prolapse after hysterectomy: a retrospective cohort study

BACKGROUND: Laparoscopic anterior sacral ligament suspension combined with dome suspension (L-ASLS + DS) and transperineal whole pelvic floor reconstruction (T-WPFR) are 2 methods for treating bladder prolapse after hysterectomy. In clinical practice, we found that L-ASLS + DS has better safety and effectiveness than T-WPFR, but there is no relevant study comparing the safety and effectiveness of these two methods. We sought to compare the efficacy and safety of L-ASLS + DS and T-WPFR in treating hysterectomy-induced bladder prolapse overa 1-year follow-up period. METHODS: A total 146 patients with bladder prolapse after hysterectomy who attended Shanxi Provincial People’s Hospital from January 2011 to January 2022 were included in this study. Patients were divided into study group and control group by voluntary means or economic reasons. In total, 75 patients received L-ASLS + DS surgery and 71 patients received T-WPFR surgery to treat hysterectomy-induced bladder prolapse. The L-ASLS + DS-treated patients comprised the study group, while the T-WPFR-treated patients comprised the control group. The perioperative indicators, curative effect, and postoperative complication rates in the follow-up period were compared between the 2 groups. RESULTS: L-ASLS + DS outperformed T-WPFR in terms of the perioperative indicators, and the incidence of postoperative complications in the L-ASLS + DS group was significantly lower than that in the T-WPFR group. CONCLUSIONS: L-ASLS + DS can be used to effectively treat bladder prolapse after hysterectomy. L-ASLS + DS reduced the incidence of postoperative complications, improved the cure rate, and was shown to be safe. Thus, it is worthy of comprehensive clinical application.