Vaginal sacrospinous ligament fixation versus abdominal sacrocolpopexy for the treatment of vaginal cuff prolapse: A retrospective study
Isil Koleli, Ercan Yilmaz
Inonu University Faculty of Medicine Department of Obstetrics and Gynecology, Malatya, Turkey
Aim: The aim of this study was to retrospectively compare the objective and the subjective results of native tissue sacrospinous ligament fixation (SSLF) and abdominal sacrocolpopexy (ASC) operation for the treatment of vaginal cuff prolapse (VCP).
Material and Methods: 25 patients who underwent native tissue SSLF and 20 patients who underwent mesh ASC procedure for VCP were evaluated with pelvic organ prolapse quantification (POP-Q) system and pelvic floor distress inventory-20 (PFDI-20) before the surgery and 12 months after surgery. The patients were asked about surgical satisfaction, postoperatively. Demographic data, intra- and postoperative complications, operation duration and hospital stay were also recorded.
Results: No difference was detected between SSLF and ASC in terms of objective success rate (88% vs. 95%; p=0.617). PFDI-20 score improved significantly after the ASC and SSLF (p<0.001). The median change of the PFDI-20 score, the pelvic organ prolapse distress inventory-6 (POPDI-6) score, the colorectal-anal distress inventory-8 (CRADI-8) score and the urinary distress inventory-6 (UDI-6) score of the groups were not different (p= 0.14; p=0.44; p=0.65; p=0.53, respectively). The median operation time of the ASC group was 34 minutes longer than the SSLF group (90 vs 56 min.) (p<0.001). Similar satisfaction rates (96% in ASC and 95% in SSLF) were found among the groups (p=1).
Conclusion: Objective and subjective results of SSLF and ASC operations were equal at 12-months after operation. SSLF can be a good option for patients with obesity and co-morbidity, and for whom general anesthesia is risky.
Keywords: Pelvic Organ Prolapse; Vaginal Vault Prolapse, Sacrocolpopexy.