Long-term follow-up after vaginal sacrospinous fixation: patient satisfaction, anatomical results and quality of life

Aigmueller, Thomas; Riss, P.; Dungl, Andrea; Bauer, Hartwig

doi:10.1007/s00192-008-0563-5

Cited by 44 publications

(33 citation statements)

References 16 publications

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“…The objective cure rate at median follow‐up of 86 months for all patients ( n = 146) for overall compartments in this study was 67.8%, with the anterior compartment being the commonest site of recurrence, accounting for 29.4%. The present findings are similar to that of a previous study by Aigmueller et al ., who reported an objective success rate of 64% with 29% anterior compartment recurrence, with a median follow‐up of 7 years . Hefni and El‐Toukhy reported a much higher success rate, 96% at mean follow‐up of 57 months, but successful outcome was based on recurrence at the apical compartment rather than overall compartments .…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcome of native tissue reconstructive vaginal surgery for advanced pelvic organ prolapse at 86 months: Hysterectomy versus hysteropexy

Pue

Hung

et al. 2015

J of Obstet and Gynaecol

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Section: Discussionmentioning

confidence: 99%

Long‐term outcome of native tissue reconstructive vaginal surgery for advanced pelvic organ prolapse at 86 months: Hysterectomy versus hysteropexy

Pue

Hung

et al. 2015

J of Obstet and Gynaecol

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“…The level of postoperative vaginal support chosen as a criterion for operative failure has been discussed in the urogynecologic literature (13). Several studies have demonstrated that strict anatomic definitions result in lower reported success rates than the use of subjective satisfaction (5, 8, 14-15). Our findings demonstrate that prolapse below the hymen indeed affects patient satisfaction, whereas women with vaginal walls at the hymen are equally satisfied as those with higher vaginal walls.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Patient Satisfaction With Michigan Four-Wall Sacrospinous Ligament Suspension for Prolapse

Larson

Smith

Berger

et al. 2013

Obstetrics &Amp; Gynecology

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Objective To describe patient satisfaction after Michigan four-wall sacrospinous ligament suspension for prolapse and identify factors associated with satisfaction. Methods Four hundred fifty-three patients were asked to rate their satisfaction with surgery and complete validated quality-of-life instruments. Postoperative support was extracted from the medical record and assessed when possible. Factors independently associated with patients who were “highly satisfied” were identified with multivariable logistic regression. Results Sixty-two percent (242/392) reported how satisfied they were 8.0±1.7 years later. Fifty-seven percent had failed prior prolapse surgery, and 56% had a preoperative prolapse ≥4 cm beyond the hymen. Ninety percent were satisfied; 76% were “completely” or “very” satisfied and they were considered “highly satisfied” for analysis. Fourteen percent reporting being “moderately” satisfied and they were considered among those “less satisfied.” Women with lower scores on the postoperative Pelvic Floor Distress Inventory-20 were more likely to be “highly satisfied.” Postoperative anatomic data was available for 67% (162/242) and vaginal support was observed at or above the hymen in 86%. Women with preoperative Baden Walker grade 3 or 4 prolapse were more likely than those with grade 2 prolapse to be “highly satisfied.” Women with advanced postoperative prolapse (Grade 3 or 4) were less likely and those with Grade 2 support were as likely to be “highly satisfied” as those with Grade 0 or 1 support. Conclusion The Michigan four-wall sacrospinous ligament suspension is an anatomically effective approach to vault suspension with a high rate of long-term patient satisfaction. Postoperative vaginal support at the hymen does not negatively affect patient’s satisfaction.

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“…However, dyspareunia can pose an important problem after vaginal surgery. The studies have reported a de novo dyspareunia rate of 3.2% after SSF (24). In a study by Hefni et al (25), only two patients (1%) had de novo dyspareunia because of vaginal stenosis that developed in relation to perineorrhaphy.…”

Section: Discussionmentioning

confidence: 98%

Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

Şentürk¹,

Güraslan²,

Çakmak³

et al. 2015

J Turkish German Gynecol Assoc

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Objective:The aim of this study was to evaluate the results of bilateral sacrospinous fixation (SSF), which was performed with surgical mesh interposition and bilateral vaginal repair. Twenty-two patients underwent SSF between 2010 and, and the results were evaluated retrospectively. The results at preoperative and postoperative 6 th , 12 th , and 18 th months of the pelvic organ prolapse quantification system (POP-Q) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) were compared using Friedman and Wilcoxon Signed Ranks tests. Values of p<0.05 and <0.01 were considered statistically significant. Material and Methods: Results:According to the POP-Q, significant healing was observed on all vaginal vault points (p=0.001), and no prolapse was observed until the 18-month follow-up stage. There were also prominent patients who felt satisfactory with respect to their sexual life according to . Conclusion:This technique appears to provide an adequate clinical resolution, and it may be the primary surgical option for women with pelvic organ prolapse. (J Turk Ger Gynecol Assoc 2015; 16: 102-6) Keywords: Pelvic organ prolapse, surgical mesh, vaginal vault Received: 29 December, 2014 Accepted: 08 March, 2015 Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up Abstract(PISQ-12) forms were completed. In addition, all patients were evaluated with Pap smear, and transvaginal ultrasonography was performed to evaluate endometrial thickness in postmenopausal patients. The operation time and the intraoperative and postoperative complications were recorded. All patients were re-examined according to the POP-Q system, and PISQ-12 forms were completed at 6, 12, and 18 months postoperatively (12). Treatment failure was defined as the presence of more than stage 1 prolapse. All surgeries were conducted under spinal anesthesia by a single surgeon experienced in pelvic floor surgery. Foley catheter was removed 6h after surgery. Postvoiding residual volume was evaluated by the Foley catheter, and PVR of less than 50 ml is considered to constitute adequate bladder emptying (13). Postvoidal residual volume was evaluated only in patients with stress urinary incontinence. All patients were discharged from the hospital on postoperative day 2. There was no necessary approval of the local ethic community because of the retrospective design of the study.The procedure was initiated with saline infusion from the posterior vaginal wall towards the ischial spine under the mucosa. After the initial midline incision was made on the posterior vaginal wall, digital blunt dissection of the coccygeus muscle was performed to access the sacrospinous ligament. The adipose tissue overlying the coccygeus muscle was removed to completely expose the sacrospinous ligament. A polypropylene suture (Prolen®; Ethicon, Norderstedt, Germany) (no:1) was bilaterally placed on the sacrospinous ligament. The tips of the 5×1.5 cm polypropylene mesh (Prolen®; Ethicon, Norderstedt, Germany) were suspended over th...

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Long-term follow-up after vaginal sacrospinous fixation: patient satisfaction, anatomical results and quality of life

Cited by 44 publications

References 16 publications

Long‐term outcome of native tissue reconstructive vaginal surgery for advanced pelvic organ prolapse at 86 months: Hysterectomy versus hysteropexy

Long‐term outcome of native tissue reconstructive vaginal surgery for advanced pelvic organ prolapse at 86 months: Hysterectomy versus hysteropexy

Long-Term Patient Satisfaction With Michigan Four-Wall Sacrospinous Ligament Suspension for Prolapse

Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

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