Long-term outcome of vaginal sacrospinous colpopexy for marked uterovaginal and vault prolapse

Hefni, M.; El‐Toukhy, Tarek

doi:10.1016/j.ejogrb.2005.11.028

Cited by 78 publications

(61 citation statements)

References 31 publications

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“…Therefore, 15 studies were excluded. Twenty-three studies were available in which outcome data for 1,764 women who underwent a vaginal hysterectomy for prolapse symptoms were analyzed separately, with a follow-up of between 9 and 60 months [4,5,6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Section: Study Selectionmentioning

confidence: 99%

“…After selection and assessment of reference lists, 11 studies and one case report were found on women who underwent a sacrospinous hysteropexy (with preservation of the uterus) [4,5,7,16,17,21,[29][30][31][32][33]. A total of 613 women who underwent a unilateral sacrospinous hysteropexy are described, with a follow-up of between 4 and 72 months.…”

Section: Study Selectionmentioning

confidence: 99%

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Vaginal surgery for uterine descent; which options do we have? A review of the literature

2008

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Several vaginal procedures are available for treating uterine descent. Vaginal hysterectomy is usually the surgeon's first choice. In this literature review, complications, anatomical and symptomatic outcomes, and quality of life after vaginal hysterectomy, sacrospinous hysteropexy, the Manchester procedure, and posterior intravaginal slingplasty are described. All procedures had low complication rates, except posterior intravaginal slingplasty, with a tape erosion rate of 0-21%. Minimal anatomical success rates regarding apical support ranged from 85% and 93% in favor of the Manchester procedure. Data on symptomatic cure and quality of life are scarce. In studies comparing vaginal hysterectomy with sacrospinous hysteropexy or the Manchester procedure, vaginal hysterectomy had higher morbidity. Because no randomized, controlled trials have been performed comparing these surgical techniques, we can not conclude that one of the procedures prevails. However, one can conclude from the literature that vaginal hysterectomy is not the logical first choice.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Vaginal surgery for uterine descent; which options do we have? A review of the literature

2008

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“…Less information is available about prolapse after sacrospinous hysteropexy. Recurrence rates vary between 6.7 (only with regard to descensus uteri) to 26% (total recurrence of descensus uteri and cystocele/rectocele) [7][8][9]12]. In the group of 60 women who underwent gynecological examination, only 3 had a recurrent descensus uteri at stage 2.…”

Section: Discussionmentioning

confidence: 99%

“…Because it has proven its efficacy in vaginal vault prolapse surgery, it might be of interest to use it as a primary technique to correct descensus uteri, the so-called sacrospinous hysteropexy. The anatomical outcome and complication rate of this operation was described in few reports, but most authors do not focus on urogenital symptoms and quality of life after sacrospinous hysteropexy [3][4][5][6][7][8]. In a previous study by our group, we concluded that the sacrospinous hysteropexy is a promising technique for the correction of descensus uteri [9].…”

Section: Introductionmentioning

confidence: 96%

The effectiveness of the sacrospinous hysteropexy for the primary treatment of uterovaginal prolapse

et al. 2007

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The objective of this study was to assess the effectiveness of sacrospinous ligament fixation of the uterus as a primary treatment of uterovaginal prolapse. In this observational study, 133 women underwent a sacrospinous hysteropexy. Data were obtained from their medical records, and standardized questionnaires about urogenital symptoms and quality of life were used. All women were invited for gynecological examination, using the Pelvic Organ Prolapse Quantification score. Ninety-nine women responded by returning the questionnaire (mean age, 59.2 and follow-up time, 22.5 months); 60 of these women underwent gynecologic examination. Eighty-four percent of women were highly satisfied about the outcome of the procedure. Serious complications were rare. The recurrence rate of descensus uteri that needed surgical treatment was 2.3%. The recurrence of cystoceles after surgery was 35%, but there were no differences in urogenital symptoms between women with or without a cystocele.

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“…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. Similarly, Holley et al (26) attributed dyspareunia to vaginal stenosis.…”

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...

show abstract

Long-term outcome of vaginal sacrospinous colpopexy for marked uterovaginal and vault prolapse

Cited by 78 publications

References 31 publications

Vaginal surgery for uterine descent; which options do we have? A review of the literature

Vaginal surgery for uterine descent; which options do we have? A review of the literature

The effectiveness of the sacrospinous hysteropexy for the primary treatment of uterovaginal prolapse

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

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