Sexual function after Anchorsure repair of sacrospinous ligament suspension in patients with pelvic organ prolapse: a prospective multicenter study

Sacrospinous ligament suspension (SSLS) is widely used to restore apical support, yet the impact of SSLS using the Anchorsure system on postoperative sexual function remains insufficiently characterized. This prospective multicenter observational cohort study enrolled 115 women with symptomatic apical pelvic organ prolapse undergoing SSLS with the Anchorsure system at two teaching hospitals in Northwest Iran between 2022 and 2024. Sexual function was assessed preoperatively and at 3‑month follow‑up using the Persian‑validated Female Sexual Function Index (FSFI). 115 women were enrolled and completed baseline FSFI, and 104 (90.4%) completed the 3‑month assessment. Mean FSFI total score increased from 19.15 ± 1.94 preoperatively to 21.84 ± 3.98 postoperatively (p < 0.001, Cohen's d = 0.88), with statistically significant improvements in desire, arousal, orgasm, satisfaction, and pain domains. Lubrication improved only minimally (mean Δ = 0.03 ± 0.71, p = 0.024, d = 0.04). Age and body mass index were not significantly associated with postoperative FSFI scores (p > 0.05). Sacrospinous ligament suspension with the Anchorsure system was associated with significant short‑term improvements in sexual function in women with apical pelvic organ prolapse, particularly in arousal, satisfaction, and pain reduction. These findings support SSLS with Anchorsure as a native‑tissue surgical option for patients who prioritize sexual health outcomes or are not candidates for more extensive abdominal procedures.