Objective To observe the clinical efficacy of the transvaginal U-shaped sacrospinous ligament fixation in the treatment of moderate and severe pelvic organ prolapse (POP).

Methods A total of 77 patients with Ⅲ to Ⅳ degree POP admitted to the First Hospital Affiliated to Shaoyang University from January 2019 to August 2021 were selected. According to different surgical methods, they were divided into mesh group(treated with modified sacrospinous ligament sling fixation with mesh implantation) and U-shaped fixation group(treated with transvaginal U-shaped sacrospinous ligament fixation). The perioperative indexes of the two groups and the scores of POP quantitative index (POP-Q), Pelvic Floor Impact Questionnaire-Short Form 7 (PFIQ-7), Pelvic Floor Distress Inventory-Short Form-20 (PFDI-20) and Polish Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores of the two groups before surgery, 6 months and 12 months after surgery were compared.

Results There were significant differences in POP-Q indexes between two groups before surgery, 6 months and 12 months after surgery (P < 0.05). PFIQ-7, PFDI-20 and PISQ-12 scores at 6 and 12 months after surgery showed significant differences compared with those before surgery (P < 0.05). There were significant differences in PFIQ-7, PFDI-20 and PISQ-12 scores 12 months after surgery between two groups compared with those of 6 months after surgery (P < 0.05). There was no significant between-group difference in PFIQ-7, PFDI-20 and PISQ-12 scores at each time point (P > 0.05).

Conclusion Both surgeries are effective in the treatment of moderate and severe pelvic organ prolapse. U-shaped fixation of the sacrospinous ligament without the use of mesh and no risk of mesh exposure erosion can reduce medical costs, surgical complications and recurrence.