Retrospective Comparative Study of Transvaginal Natural Orifice Transluminal Endoscopic Surgery and Vaginal Sacrospinous Ligament Fixation for Pelvic Organ Prolapse

<title>Abstract</title> <p>Objective A retrospective analysis was performed to evaluate the clinical efficacy, perioperative indicators and safety of transvaginal natural orifice transluminal endoscopic sacrospinous ligament fixation compared to vaginal sacrospinous ligament fixation in the treatment of pelvic organ prolapse. This study aims to provide a reference for the selection of clinical treatment strategies. Methods A retrospective analysis was conducted on 20 patients (experimental group) who underwent transvaginal natural orifice transluminal endoscopic sacrospinous ligament fixation and 100 patients (control group) who underwent vaginal sacrospinous ligament fixation in the People's Hospital of Inner Mongolia Autonomous Region from July 2023 to December 2025. Taking age, BMI, etc. as covariates, propensity score matching was conducted at a ratio of 1:4. Eventually, 20 cases in the experimental group and 80 cases in the control group were included in the analysis. Compare the baseline data before and after matching, perioperative indicators, complications, and postoperative anatomical and functional scores, etc. Results Prior to matching, the two groups differed in terms of age and parity. (P &lt; 0.05). There was no difference in the baseline data after matching (P &gt; 0.05). The experimental group had less intraoperative blood loss, less postoperative pain, shorter hospital stay (P &lt; 0.05), and slightly longer operation time (P &lt; 0.05). The C point in the experimental group improved significantly compared with the control group 6 months after the operation (P &lt; 0.05), and the improvements of PFDI-20, PFIQ-7 and PGI-I in both groups were comparable 6 months after the operation (P &gt; 0.05). The incidence of pelvic pain and total complications in the experimental group was lower than that in the control group, and the difference was statistically significant (P &lt; 0.05), with good safety. Conclusion Transvaginal natural orifice transluminal endoscopic sacrospinous ligament fixation for pelvic organ prolapse has advantages such as less intraoperative bleeding, faster postoperative recovery, lower complication rate, and better recovery of pelvic floor function compared with vaginal sacrospinous ligament fixation. Although the operation time may vary, the overall efficacy is definite and the safety is high. It can be used as one of the preferred surgical methods for the clinical treatment of POP.</p>