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Transvaginal sacrospinous ligament fixation for treatment of vaginal prolapse
1Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Purpose:
We performed sacrospinous ligament fixation for the treatment of vaginal apical prolapse in a urological practice.
Materials And Methods:
A total of 24 patients underwent sacrospinous ligament fixation for the treatment of vaginal prolapse. In 13 patients another procedure was done concomitantly through the same exposure for treatment of stress urinary incontinence and/or pelvic relaxation.
Results:
At a mean followup of 13.8 months (range 4 to 26) 18 of 24 patients had complete resolution of vaginal prolapse, while 5 had a clinically significant recurrence. Two patients underwent repeat sacrospinous ligament fixation with a good result, colpocleisis was performed in 1 and 2 are being managed conservatively. One patient had a cystocele postoperatively. All recurrences were within 6 months. Complications were uncommon. One patient suffered a small rectal laceration that was repaired primarily and she had no further clinical sequelae. If the 2 patients who underwent repeat sacrospinous ligament fixation are considered, the overall success rate was 87.5% (21 of 24).
Conclusions:
Sacrospinous ligament vaginal fixation can be used safely and effectively to treat vaginal prolapse in urological practice, either alone or combined with another transvaginal procedure for the treatment of stress urinary incontinence.