# Sacrospinous Ligament Fixation After Failed Sacrocolpopexy: A Case Series

## TL;DR

This case series shows that sacrospinous ligament fixation can safely treat recurrent apical prolapse after a failed sacrocolpopexy, offering a less invasive option.

## Contribution

The study introduces sacrospinous ligament fixation as a feasible alternative to redo surgery for recurrent apical prolapse.

## Key findings

- All patients showed sustained apical support with POP-Q C −8 at 3- and 12-month follow-ups.
- Symptoms and quality of life improved significantly, as measured by ICIQ-VS scores.
- Mild, asymptomatic anterior compartment descent occurred in two cases.

## Abstract

Recurrent apical prolapse after failed sacrocolpopexy poses a surgical challenge, with limited evidence on surgical treatments. This case series evaluates the feasibility and 1‐year outcomes of sacrospinous ligament fixation (SSLF) of the residual cervix in this setting. Three postmenopausal women with symptomatic recurrent apical prolapse underwent SSLF after prior laparoscopic sacrocolpopexy. At 3‐ and 12‐month follow‐up, all patients showed sustained apical support (POP‐Q C −8), with significant improvement in symptoms and quality of life (ICIQ‐VS scores). Mild, asymptomatic anterior compartment descent was noted in two cases. SSLF of the cervix appears to be a safe, effective, and minimally invasive alternative to redo sacrocolpopexy for selected patients with recurrent apical prolapse.

Sacrospinous ligament fixation of the residual cervix provides safe and durable apical support after failed sacrocolpopexy, offering a minimally invasive alternative to redo sacrocolpopexy.