Sacrospinous colpopexy at vaginal hysterectomy: method, results and follow up in 75 patients

This study reviews our experience with sacrospinous colpopexy done at the time of vaginal hysterectomy over a period of 3 years, and discusses the indications, outcome and safety of the technique. Between January 1996 and December 1998, 75 patients had sacrospinous colpopexy at the time of vaginal hysterectomy. The mean age of patients was 57.1 years. Simultaneous bilateral vaginal oophorectomy was done in 36 patients, anterior colporrhaphy in 56, and posterior colporrhaphy in 24. All patients underwent perineorrhaphy. Dissection and obliteration of the enterocoele sac was performed whenever encountered. Patients were seen at 2, 6 and 12 months following surgery and then yearly thereafter. The mean operative time was 85 minutes, mean uterine weight was 101 grams and mean blood loss was 137 ml. The mean follow-up period was 15 months. The vaginal vault remained well supported in 96.7%, with recurrent cystocoele in six patients (9.8%), recurrent rectocoele in 1.3%, and shortvagina in 3.3%. At 1-year follow up, 28% of those who were sexually active prior to surgery reported an improvement in sexual function. When dealing with uterovaginal prolapse, sacrospinous colpopexy performed at the time of vaginal hysterectomy is an effective treatment option for vaginal vault support.