Comparative study between vaginal sacrospinous ligament fixation with abdominal sacrocolpopexy

Abstract

Vaginal vault prolapse is about 4-6 per 1000 but it is increasing with increase in life expectancy with more number of years in menopausal age. It is not a common condition following abdominal and vaginal hysterectomy. It has a negative impact on the quality of life of women due to incontinence of urine, irregular defecation symptoms and sexual dysfunction along with psychosocial problems. This study compares the efficacy of most two successful surgeries which were done by abdominal and vaginal route for correcting post hysterectomy vault prolapse by postoperative assessment and at least 6 to 12 months follow up. This is the retrospective case series among post hysterectomy women attending the Gynae OPD in SVBP hospital associated with LLRM medical college Meerut from January 2022 to January 2023. Study population included 19 women divided into two groups; group 1 includes 8 women who underwent unilateral sacrospinous ligament fixation and group 2 includes 11 women who underwent abdominal sacrocolpopexy. In demographic and clinical features between the two groups, there is no statistically difference found in terms of mean age, mean weight, mean BMI and mean parity. Hence, both groups are comparable. The operating time is longer in ASC (85.90±40.23 minutes) group when compared to SSF group (43.43±6.9 minutes) (p value= 0.00096), blood loss reported in ASC (341.72±37.14 ml) slightly more than in SSF group (237.5±32.84 ml) (p value= 0.0001) and mean hospital stay is longer in ASC (6±5.1 days) than SSF group (3.2±0.9 days) (p value=0.0001). Other complications like postoperative pyrexia, wound infection, urinary complaints were higher in ASC group and at follow up, the mean vaginal length was longer in ASC (6.9±0.8 cm) then SSF (5.2±0.8cm) group (p value=0.0005). We concluded that as the ultimate aim of vault prolapse surgery is to improve the function and restoring anatomy and to improve the quality of life, in that respect, both abdominal sacrocolpopexy and sacrospinous ligament fixation both are effective methods and less complications are noted in SSF group. It also depends on the hands of an expert, though recovery time is faster in SSF than ASC group.