Sacrospinous fixation for the prolapsed vaginal vault

Area of Science:

• Gynecology
• Urogynecology
• Pelvic Reconstructive Surgery

Background:

• Pelvic organ prolapse (POP) significantly impacts women's quality of life.
• Surgical management of POP aims to restore pelvic anatomy and function.
• Transvaginal sacrospinous ligament fixation is a recognized surgical technique for apical POP.

Purpose of the Study:

• To retrospectively evaluate the safety and efficacy of transvaginal sacrospinous ligament fixation.
• To assess outcomes including operative time, blood loss, complications, and recurrence rates.
• To determine the suitability of this procedure as an alternative surgical approach.

Main Methods:

• Retrospective review of 54 patients undergoing transvaginal sacrospinous ligament fixation.
• Data collection on operative parameters, intraoperative complications, and postoperative follow-up.
• Analysis of recurrence rates and incidence of associated pelvic floor disorders.

Main Results:

• Mean operative time: 15 minutes; Mean blood loss: 126 cm³.
• Low complication rate, with one rectal laceration requiring primary repair.
• Low recurrence rate of vaginal vault prolapse (2/54) over a mean follow-up of 28 months.
• Incidence of cystocele (5.5%), rectocele (1.8%), enterocele (9.2%), stress incontinence (5.5%), and dyspareunia (9.2%) reported.

Conclusions:

• Transvaginal sacrospinous ligament fixation is a safe and effective procedure for treating pelvic organ prolapse.
• It serves as a viable alternative to hysterectomy, particularly for elderly or medically compromised patients.
• The procedure offers benefits such as avoiding laparotomy and preserving vaginal function.