{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:45:59Z","timestamp":1791434759147,"version":"4.3.3"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pelvic organ prolapse (POP) significantly impacts women's quality of life, often necessitating surgical intervention. Sacrospinous ligament fixation (SSF) and uterosacral ligament suspension (USLS) are commonly performed, mesh\u2010free procedures for apical prolapse repair. While SSF provides durable support, it may alter vaginal axis alignment and compromise visualization, whereas traditional USLS is associated with ureteral complications. This study compares the perioperative and postoperative outcomes of SSF and Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) high uterosacral ligament suspension (VN\u2010HUSLS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective case series was conducted at Zeynep Kamil Hospital and included 50 patients with Stage 3 or 4 POP who underwent vaginal hysterectomy followed by SSF (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927) or VN\u2010HUSLS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923). Demographic data, operative times, hospitalization duration, POP\u2010Q scores, recurrence rates, and complications were analyzed using SPSS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant differences were found in age, BMI, or preoperative POP stage (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Prolapse\u2010specific surgical time was significantly shorter in the VN\u2010HUSLS group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). All VN\u2010HUSLS patients underwent bilateral adnexectomy with preoperative indications, compared to five in the SSF group. Postoperative POP\u2010Q scores showed better anatomical correction in the VN\u2010HUSLS group, with sustained improvements at 6\u2010 and 12\u2010month follow\u2010ups. In the SSF group, two patients experienced recurrence, one at 6\u2009months (Ba point +2) and the other at 12\u2009months (Ba point +3). In the VN\u2010HUSLS group, one patient was found to have Ba point at +1 at the 12\u2010month follow\u2010up, but this did not result in any additional symptoms for the patient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VN\u2010HUSLS is a promising alternative to SSF, improving surgical outcomes while reducing recurrence and postoperative morbidity. Further studies are needed to evaluate long\u2010term outcomes and postoperative sexual function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70017","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T07:08:52Z","timestamp":1753427332000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["High uterosacral ligament suspension with vaginal natural orifice transluminal endoscopic surgery: A better alternative to sacrospinous fixation in postmenopausal women?"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4690-1731","authenticated-orcid":false,"given":"Ay\u015fe Bet\u00fcl","family":"Albayrak Denizli","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Health Sciences Zeynep Kamil Women's and Children's Disease Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2246-4899","authenticated-orcid":false,"given":"Eralp","family":"Bulutlar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Health Sciences Zeynep Kamil Women's and Children's Disease Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6979-0854","authenticated-orcid":false,"given":"Gizem Berfin","family":"Uluutku Bulutlar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Health Sciences Haydarpa\u015fa Numune Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7107-9719","authenticated-orcid":false,"given":"Sad\u0131k","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Health Sciences Zeynep Kamil Women's and Children's Disease Training and Research Hospital  Istanbul 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