Bilateral transvaginal sacrospinous colpopexy: preliminary experience

Area of Science:

• Urogynecology
• Pelvic reconstructive surgery

Background:

• Pelvic organ prolapse is a common condition affecting women.
• Sacrospinous ligament suspension is a surgical technique used to treat vaginal vault prolapse.

Purpose of the Study:

• To evaluate the feasibility and outcomes of bilateral sacrospinous colpopexy.
• To compare the success rates of bilateral sacrospinous colpopexy in patients with uterine prolapse versus posthysterectomy vaginal vault prolapse.

Main Methods:

• Prospective evaluation of 66 patients with uterine prolapse or posthysterectomy vaginal vault prolapse.
• Assessment for bilateral sacrospinous colpopexy in 40 patients.
• Comparison with abdominal sacral colpopexy in 26 patients.

Main Results:

• Bilateral sacrospinous colpopexy was performed in 56% of uterine prolapse patients and 73% of posthysterectomy vaginal vault prolapse patients.
• No recurrent vaginal cuff prolapse was detected during follow-up (6-40 months).
• Three patients in the bilateral fixation group developed distention cystoceles, with one requiring anterior colporrhaphy.

Conclusions:

• Bilateral sacrospinous colpopexy is technically feasible, particularly in posthysterectomy vaginal vault prolapse.
• Intraoperative judgment is crucial for successful bilateral suspension without tension.
• While effective for prolapse, potential complications like cystocele formation should be considered.