An unusual complication following sacrospinous fixation for vaginal vault prolapse

Author(s):  
Vandna Verma ◽  
Kristina Savickaite ◽  
Smita Rajshekhar ◽  
Ashish Pradhan
2008 ◽  
Vol 68 (S 01) ◽  
Author(s):  
A Uzeda ◽  
M Baumann ◽  
C Salvisberg ◽  
M Mueller ◽  
A Kuhn

2009 ◽  
Vol 2009 ◽  
pp. 1-9 ◽  
Author(s):  
Azubuike Uzoma ◽  
K. A. Farag

Introduction. Vaginal vault prolapse is a common complication following vaginal hysterectomy with negative impact on women's quality of life due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanism for the uterus and vagina is important in making the right choice of corrective procedure. Management should be individualised, taking into consideration the surgeon's experience, patients age, comorbidities, previous surgery and sex life.Result. Preexisting pelvic floor defect prior to hysterectomy is the single most important risk factor for vault prolapse. Various surgical techniques have been advanced at hysterectomy to prevent vault prolapse. Studies have shown the McCall's culdoplasty under direct visualisation to be superior. Vault prolapse repair rely on either the use of patient's tissue or synthetic materials and can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures, with literature in favour of abdominal sacrocolpopexy over sacrospinous fixation due to its reported higher success rate of about 90%. Other less commonly performed procedures include uterosacral ligament suspension and illiococcygeal fixation, both of which are equally effective, with the former having a high risk of ureteric injury. Colpoclesis will play a greater role in the future as the aging population increases. Mesh procedures are gaining in popularity, and preliminary data from vaginal mesh procedures is encouraging. Laparoscopic techniques require a high level of skill and experience. There are many controversies on the mechanism of prolapse and management techniques, which we have tried to address in this article.Conclusion. As the aging population increases, the incidence of prolapse will also rise, older techniques using native tissue will continue, while new techniques using the mesh needs to be studied further. The later may well be the way forward in future.


2008 ◽  
Vol 23 (5) ◽  
pp. 1013-1017 ◽  
Author(s):  
Marc Baumann ◽  
Claudia Salvisberg ◽  
Michel Mueller ◽  
Annette Kuhn

2005 ◽  
Vol 271 (4) ◽  
pp. 358-362 ◽  
Author(s):  
Agnaldo L. Silva-Filho ◽  
Admário S. Santos-Filho ◽  
Octacílio Figueiredo-Netto ◽  
Sérgio A. Triginelli

2017 ◽  
Vol 66 (1) ◽  
pp. 46-55
Author(s):  
Dmitry D Shkarupa ◽  
Alexandr A Bezmenko ◽  
Nikita D Kubin ◽  
Ekaterina A Shapovalova ◽  
Alexey V Pisarev

Introduction. Frequency of vaginal vault prolapse (VVP) requiring surgical repair is up to 6-8% and 11.6-45% in patients with prior hysterectomy for uterine prolapse. Reported recurrence rate of VVP following different techniques of surgical correction is up to 10%.Objective: to evaluate the effectiveness of the novel technique: bilateral sacrospinous fixation of reconstructed vaginal wall (neocervix) by monofilament polypropylene apical sling (Urosling 1; Lintex, Saint Petersburg, Russia) in surgical treatment of VVP.Methods. This prospective study involved 61 women suffering from post-hysterectomy prolapse. To evaluate the results of surgical treatment, data of a vaginal examination (POP-Q), uroflowmetry, bladder ultrasound, validated questionnaires were used. All listed parameters were determined before the surgery and at control examinations in 1, 6, 12 months after the treatment.Results. Mean operation time was 35 minutes. No cases of intraoperative damage to the bladder/rectum, as well as clinically significant bleeding were noted. 12-months anatomical cure rate (≤ stage I, POP-Q) was 100%, 94.4% and 100% for apical, anterior and posterior vaginal compartments, respectively. At 1 month of follow-up stress urinary incontinence de novo and urgency de novo were noted in 6.5% and 4.9%, respectively. Statistically significant (p < 0.05) improvement in peak flow rate was observed according to uroflowmetry. Comparison of the scores by the questionnaires revealed a significant improvement in the quality of life in the postoperative period.Conclusion. Bilateral sacrospinous fixation of reconstructed vaginal wall (neocervix) by monofilament polypropylene apical sling appears to be effective and safe method for treatment patients with vaginal vault prolapse.


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.


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