A comparative study of post-surgical outcome between abdominal sacrocolpopexy and abdominal high uterosacral suspension for vault prolapse

Abstract

Background: Pelvic organ prolapse has become an important health and social issue. With increasing life expectancy in women risk of post hysterectomy vault prolapse. Various operartive procedures have been suggested for vault prolapse. This study aims to compare the surgical outcome of the abdominal High Uterosacral ligament suspension and the abdominal Sacrocolpopexy. Materials and Methods: This is a retrospective study. A total of 50 patients with history of reconstructive surgery for stage 3 vault prolapse 6months back were included in the study. These patients were divided into 2 groups. Group I included patients who had undergone abdominal sacrocopopexy for vault prolapse. Group II included patients who had high uterosacral suspension for vault prolapsed. Each patient was thoroughly examined and meticulous history was taken and recorded. The anterior posterior and central compartment defect were analysed using Pelvic Organ Prolapse Quantification (POP-Q) and Total Vaginal Length was measured. Patients's subjective assessment of quality of life post surgery was assessed using (i) pelvic floor distress inventory (PFDI-20) &(ii) pelvic floor impact Questionnaire.(PFIQ-7) [9] . Results: Out of 50 patients group I(sacrocolpopexy group) included 28 patients. Group II (high uterosacral suspension group) had 22 patients. Sacrocolpopexy proved to be better to high uterosacral suspension in the posterior compartment defect, the postoperative mean for Bp was (-2.49±1.89 versus -2.04±1.28, P=0.008). The high uterosacral suspension was superior to sacrocolpopexy in the anterior compartment. Aa(-2.38±1.1Vs--2.78±0.42, P<0.04). Both sugeries were equally effective in treating central compartment defects. Total vaginal length was more in sacrocopopexy gp. (6.43±0.72 versus 4.89±0.69, P=0.04) Conclusion: Sacrocolpopexy is more beneficial for posterior compartment defects in pelvic organ prolapse. Uterosacral suspension is beneficial for treatment of anterior compartment defects and urinary symptoms. Both surgeries are equally effective in central compartment defect treatment.