scholarly journals Medium-Term Outcomes of Laparoscopic Pubocervical Fascia Reconstruction and Sacrospinous Ligament Fixation for Pelvic Organ Prolapse

2020 ◽  
Author(s):  
Yunshan Zhu ◽  
Xiao Zhang ◽  
Danxia Chen ◽  
Guangxiao Li ◽  
Shanliang Shang ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Posterior Approach ◽  
Pelvic Organ ◽  
Clinical Effects ◽  
Cure Rate ◽  
Medium Term ◽  
Sacrospinous Ligament ◽  
Sacrospinous Ligament Fixation ◽  
Objective Cure

Abstract Background: The aim of this study was to investigate the medium-term outcomes of laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach for severe pelvic organ prolapse (POP). Methods: A total of 129 patients with severe POP quantitation stage III-IV who underwent laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach at Sir Run Run Shaw Hospital College of Medicine, Zhejiang University, Hangzhou, China between September 2014 and December 2018 were enrolled in this study. One hundred twenty-four patients were followed up for at least 1 year. The results and complications were recorded. Data were retrospectively reviewed. Results: All the patients underwent laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with a posterior approach. The average follow-up time was 32.27±12.90 months. The objective cure rate for those who underwent hysterectomy was 91.7 % (100/109), and no patient experienced apical vaginal prolapse. The objective cure rate for those who retained uterus was 66.67% (10/15). Suture-related complications were recorded.Conclusions: Laparoscopic pubocervical fascia reconstruction and sacrospinous ligament fixation with the posterior approach is a safe, minimally invasive, and effective method for patients with severe POP. Long-term follow-up is required to confirm the clinical effects.

The effect of reconstructive vaginal surgery on quality of life and sexual functions in postmenopausal women with advanced pelvic organ prolapse in intermediate-term follow-up

2021 ◽  
pp. 205336912110097
Author(s):  
Suna Y Karaca
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Sexual Function ◽  
Pelvic Organ ◽  
Sacrospinous Ligament ◽  
Sacrospinous Ligament Fixation ◽  
Mccall Culdoplasty ◽  
Advanced Pelvic Organ Prolapse

Objective To compare sexual function and quality of life in women who underwent McCall culdoplasty versus sacrospinous ligament fixation for pelvic organ prolapse. Materials and methods This study was conducted in our urogyanecology clinic between July 2015 and June 2019. We included sexually active postmenopausal women who had undergone either McCall culdoplasty ( n:80 patients) or sacrospinous ligament fixation ( n:38 patients) procedure for threatened POP. Patients in both groups were matched according to age and body mass index. Sexual function between both groups was evaluated with the pelvic organ prolapse/urinary incontinence sexual function 12 patient-reported outcome measures (PROMs) and quality of life with the prolapse quality of life (PQOL) PROMs. Results Emotional domain was low in the McCall culdoplasty group (21.4 ± 10.1 vs. 30.8 ± 15.2; p = 0.03). There were no significant differences in other P-QOL domains. Pain during intercourse was more in the sacrospinous ligament fixation group (2.9 ± 1.6 vs. 1.3 ± 1.1; p = 0.04). The mean operation time in the McCall culdoplasty group was shorter than the sacrospinous ligament fixation group ( p = 0.03). There was no difference between the two surgical procedures performed in terms of intraoperative blood loss and hospital stay. The prevalence of recurrence in the McCall culdoplasty group was 6.2%, and that of sacrospinous ligament fixation was 5% ( p = 0.75) in one year follow-up. Conclusion Our study demonstrated that McCall culdoplasty has a more positive effect on QOL and sexuality than sacrospinous ligament fixation in appropriately selected patients. McCall culdoplasty could be considered as a good option in the treatment of advanced pelvic organ prolapse in elderly patients.

scholarly journals Outcome of Sacrospinous Ligament Fixation of the Vault during Repair of Pelvic Organ Prolapse

2018 ◽  
Vol 16 (3) ◽  
pp. 321-324 ◽  
Author(s):  
Ganesh Dangal ◽  
Rekha Poudel ◽  
Ranjana Shrestha ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Hospital Stay ◽  
Pelvic Organ ◽  
Sacrospinous Ligament ◽  
Vault Prolapse ◽  
Buttock Pain ◽  
Sacrospinous Fixation ◽  
Sacrospinous Ligament Fixation ◽  
Operative Complications

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. 

Outcome of Sacrospinous Ligament Fixation of the Vault during Repair of Pelvic Organ Prolapse

2018 ◽  
Vol 16 (3) ◽  
pp. 321-324 ◽  
Author(s):  
Ganesh Dangal ◽  
Rekha Poudel ◽  
Ranjana Shrestha ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Hospital Stay ◽  
Pelvic Organ ◽  
Stage Iii ◽  
Sacrospinous Ligament ◽  
Vault Prolapse ◽  
Buttock Pain ◽  
Sacrospinous Ligament Fixation ◽  
Operative Complications

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 and need of removal of sacrospinous fixation suture and recurrence of vault 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 in7 (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.

scholarly journals Should we add unilateral sacrospinous ligament fixation to vaginal hysterectomy in management of stage 3 and stage 4 pelvic organ prolapse?

2015 ◽  
Vol 12 (3) ◽  
pp. 144-150 ◽  
Author(s):  
Elif Ağaçayak ◽  
Senem Yaman Tunç ◽  
Mehmet Sait İçen ◽  
Serdar Başaranoğlu ◽  
Fatih Mehmet Fındık ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Vaginal Hysterectomy ◽  
Pelvic Organ ◽  
Sacrospinous Ligament ◽  
Sacrospinous Ligament Fixation ◽  
Stage 4

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

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Virva Nyyssönen ◽  
Anne Talvensaari-Mattila ◽  
Markku Santala
Keyword(s):  
Pelvic Organ ◽  
Vaginal Vault Prolapse ◽  
University Hospital ◽  
Vaginal Vault ◽  
Sacrospinous Ligament ◽  
Vault Prolapse ◽  
Sacrospinous Ligament Fixation ◽  
Exact Test ◽  
Intravaginal Slingplasty

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.

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