Objective To investigate the clinical efficacy of laparoscopic vaginal apex pectineal ligament suspension combined with anterior and posterior colporrhaphy for moderate to severe pelvic organ prolapse (POP). Methods Ninety patients with moderate to severe POP were selected as the study subjects and randomly divided into an observation group and a control group using the random number table method, with 45 cases in each group. The observation group underwent laparoscopic vaginal apex pectineal ligament suspension combined with anterior and posterior colporrhaphy. The control group received laparoscopic high uterosacral ligament suspension combined with anterior and posterior colporrhaphy. The two groups were compared in terms of operative duration, intraoperative blood loss, incidence of intraoperative bladder injury, duration of indwelling urinary catheter, incidence of new-onset postoperative urinary incontinence and postoperative hospital stay. Both the pelvic organ prolapse quantification system (POP-Q) and pelvic floor function assessed by the pelvic floor distress inventory-short form (PFDI-20) were compared applied at four time points: preoperatively, 1 month, 3 months and 6 months postoperatively. Results The observation group had a longer operative duration than the control group. Meanwhile, it showed shorter postoperative hospital stay, shorter duration of indwelling urinary catheter, less intraoperative blood loss, and a lower incidence of new-onset postoperative urinary incontinence (P<0.05). At 3 and 6 months postoperatively, POP-Q staging in the observation group was superior to that in the control group (P<0.05). At 1 month, 3 month, and 6 months postoperatively, the scores of urinary distress inventory-6, pelvic organ prolapse distress inventory-6, and colorectal-anal distress inventory-8 in both groups were lower than their preoperative scores, and the observation group's scores of the above three subscales were lower than the control group's (P<0.05). Conclusion Compared with laparoscopic high uterosacral ligament suspension combined with anterior and posterior colporrhaphy, laparoscopic vaginal pettineal ligament suspension combined with anterior and posterior colporrhaphy for POP can shorten postoperative hospital stay, achieve better correction of POP, relieve pelvic floor-related symptoms, reduce new-onset postoperative urinary incontinence, and facilitate the recovery of plevic floor function.

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