Posterior Intravaginal Slingplasty versus Unilateral Sacrospinous Ligament Fixation in Treatment of Vaginal Vault Prolapse

Abstract

Objective. To investigate the differences in efficacy, postoperative complications, and patient satisfaction between posterior intravaginal slingplasty (PIVS) and unilateral sacrospinous ligament fixation (SSLF) procedures. Study Design. A retrospective study of thirty-three women who underwent PIVS or SSLF treatment for vaginal vault prolapse in Oulu University Hospital. The patients were invited to a follow-up visit to evaluate the objective and subjective outcomes. Median follow-up time was 16 months (range 6–52). The anatomical outcome was detected by the Pelvic Organ Prolapse Quantification (POP-Q) system. Information on urinary, bowel, and sexual dysfunctions and overall satisfaction was gathered with specific questionnaire. The data were analyzed using Mann-Whitney U test and Fisher's exact test. Results. Mesh erosion was found in 4 (25%) patients in the PIVS group. Anatomical stage II prolapse or worse (any POP-Q point ≥−1) was detected in 8 (50%) patients in the PIVS group and 9 (53%) patients in the SSLF group. Overall satisfaction rates were 62% and 76%, respectively. Conclusion. The efficacy of PIVS and SSLF is equally poor, and the rate of vaginal erosion is intolerably high with the PIVS method. Based on our study, we cannot recommend the usage of either technique in operative treatment of vaginal vault prolapse.

Sacrospinous Ligament Fixation in Patients having Second-degree Uterine Prolapse

“…The UTI seen in patients in both groups (5 and 3 cases respectively) may be due to catheter insertion. Also in a study performed by Demirci et al, 7 UTI was found in 10% of cases 6 where sacrospinous fixation was done. And UTI was seen in one case in a study performed by Gupta.…”

“…However, in a study performed by Demirci et al 7 , the operative time was 40.9 ± 28.3 minutes. The operative time was 53 (38-110) minutes in a study performed by Nyyssönen et al 6 Hemoglobin levels in both groups changed minimally, denoting minimal blood loss in all patients. But in a study done by Demirci et al, 7 the preoperative hemoglobin (Hb) level was 12.1 ± 1.8 gm/dL and postoperative Hb level was 10.0 ± 1.7 gm/dL.…”

“…In these conditions, vaginal correction is better than abdominal approach, and sacrospinous ligament fixation shows 96 to 98% effectiveness in the management of posthysterectomy vaginal vault prolapse. 6 Many factors may lead to genital prolapse, such as multiparity, forceps or ventouse vaginal deliveries, largesized fetus, protracted labor, and congenital weakness of fascial support. 7 Risk factors for pelvic organ prolapse include recurrent vaginal deliveries, obesity, and advanced age.…”

Vaginal vault reconstruction and apical sling in the treatment of post-hysterectomy prolapsE

“…Одним из распространенных поводов для данного оперативного вмешатель-ства является пролапс тазовых органов (ПТО). При этом данные литературы свидетельствуют о высокой вероятности выпадения купола вла-галища в послеоперационном периоде, дости-гающей 11,6-45 % [3,4].…”

Surgical Treatment of Patients With Pelvic Prolapse

“…Следует отметить, что больные с выпадением купола влагалища после перенесенной экстирпации/ампутации матки занимают особое место. Частота данного осложнения составляет от 11,6 до 45% [11]. По данным литературы, симптомы стресс-недержания мочи диагностируют у 38,6-70,1% женщин, нарушения дефекации развиваются более чем у 36,5% [1].…”