Bilateral minimal tension sacrospinous fixation in pelvic organ prolapse: an observational study

Author(s):  
Anke R. Mothes ◽  
Luise Wanzke ◽  
Marc P. Radosa ◽  
Ingo B. Runnebaum
2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Zelalem Mengistu ◽  
Mezigebu Molla

Abstract Introduction Genitourinary tract trauma caused by ox horn injury in the presence of pelvic organ prolapse (POP) is an extremely rare phenomenon and associated with devastating morbidity. Case presentation A 50-year-old multiparous postmenopausal woman from rural northwest Ethiopia presented with the primary complaint of urinary incontinence 6 days after she suffered ox horn injury to her prolapsed genitalia. She had stage 3 pelvic organ prolapse with the leading point being the cervix. The anterior vaginal and posterior bladder walls were disrupted with visible draining of the left ureter. The wound was dirty and edematous with whitish discharge. She was admitted to the urogynecology ward and provided with wound care until the infection subsided. Apical prolapse suspension was performed using right sacrospinous fixation, and bladder repair was carried out 6 weeks following the prolapse suspension. She recovered well and was continent when discharged. Conclusion Ox horn injury involving the female lower urogenital tract in the presence of POP is extremely rare. Late presentation after sustaining injury is associated with increased risk of morbidity and long hospital stay, and treatment requires multistage surgery.


Author(s):  
Elisia Elisia ◽  
Tyas Priyatini

Abstract Objective: To determine the incidence of post-operative urinary retention after pelvic organ prolapse reconstruction and associated factors. Method: This was a prospective cohort study conducted in Dr. Cipto Mangunkusumo and another associate hospital. We recruited women planned for pelvic organ prolapse reconstruction from April 2013 to April 2015. Inclusion and exclusion criteria were women with pelvic organ prolapse (2nd, 3rd and 4th degree) without prior urinary retention, drugs affecting bladder function, and history of bladder injury. After surgery, urinary catheter was applied for 24 hours. Six hours apart from urinary catheter released, residual urine was measured. Urinary retention was defined as residual urine more than 100 ml. Result: Of 200 subjects, 59 of them (29.5%) classified as having urinary retention. No association found between age, body mass index (BMI), degree of prolapse, degree of cystocele and urinary tract infection toward urinary retention. Total vagina hysterectomy + anterior colporaphy + colpoperineoraphy + sacrospinous fixation and reconstruction duration more than 130 minutes were associated with urinary retention (relative risk (RR) 3.66; 95% CI 2.91-4.60; p


2018 ◽  
Vol 29 (3) ◽  
pp. 449-449
Author(s):  
Cathrine Reimers ◽  
Jette E. Stær-Jensen ◽  
Franziska Siafarikas ◽  
Kari Bø ◽  
Marie Ellström Engh

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Salvatore Giovanni Vitale ◽  
Antonio Simone Laganà ◽  
Marco Noventa ◽  
Pierluigi Giampaolino ◽  
Brunella Zizolfi ◽  
...  

Objective. Our aim was to study the efficacy of transvaginal bilateral sacrospinous fixation (TBSF) and its impact on quality of life (QoL) and sexual functions in women affected by second recurrences of vaginal vault prolapse (VVP). Materials and Methods. We performed a prospective observational study on 20 sexually active patients affected by second recurrence of VVP, previously treated with monolateral sacrospinous fixation. TBSF was performed in all the patients. They had been evaluated before the surgery and at 12-month follow-up through pelvic organ prolapse quantification (POP-Q) system, Short Form-36 (SF-36), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Results. At 12-month follow-up, 18 out of 20 (90%) patients were cured of their recurrent VVP. No major intra- and postoperative complications occurred. We found a significant improvement in 4/5 POP-Q landmarks (excluding total vaginal length), SF-36, and PISQ-12 scores. Conclusion. According to our data analysis, TBSF appears to be safe, effective, and able to improve both QoL and sexual functions in patients affected by second recurrence of VVP after previous monolateral sacrospinous fixation.


2017 ◽  
Vol 29 (3) ◽  
pp. 441-448
Author(s):  
Cathrine Reimers ◽  
Jette E. Stær-Jensen ◽  
Franziska Siafarikas ◽  
Kari Bø ◽  
Marie Ellström Engh

2018 ◽  
Vol 16 (3) ◽  
pp. 321-324 ◽  
Author(s):  
Ganesh Dangal ◽  
Rekha Poudel ◽  
Ranjana Shrestha ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
...  

Background: Pelvic organ prolapse includes descent of anterior/ posterior wall and apical (vault) prolapse with significant morbidity. In this study we evaluated the outcome of sacrospinous ligament fixation of vault through vaginal approach as part of the repair for massive uterovaginal (pelvic organ prolapse stage III and stage IV) and vault prolapse. Methods: This study on sacrospinous ligament fixation along with repair for pelvic organ prolapse at Kathmandu Model Hospital from November 2016 to April 2018 was done to assess the outcome in terms of early (during hospital stay) and delayed (six months) post-operative complications, need of removal of sacrospinous fixation suture and recurrence of prolapse. Results: Out of 95 pelvic organ prolapse patients, 80 (84%) were post-menopausal, 28 (29.4%) were in the age group of 70-79 years.  There were 61 (64%) POPQ stage III. The post-operative complications during post-operative hospital stay were pain over right buttock in 42 (44%), urinary retention in 7 (7%) and UTI in 7 (7%). Sacrospinous suture was released in two patients for severe pain over right buttock.  At one-week follow-up, 35 (36%) had right buttock pain of moderate severity and 8 (8%) had vaginal cuff infection. Sacrospinous suture was removed in one patient for neuropraxia two weeks following surgery. At four weeks follow-up, 25 (26%) patients had mild right buttock pain relieved by oral NSAIDs on need. At six months follow-up, five had occasional buttock pain, six had some recurrences and two had some vault prolapse and one each had short vagina and stress incontinence. Conclusions: Sacrospinous   ligament   fixation   is   a   good   procedure   for   the management of pelvic organ prolapse with better long-term outcome if performed with good surgical expertise. Keywords:  Prolapse; repair; sacrospinous fixation; vaginal hysterectomy. 


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