scholarly journals Sacrocolpopexy in management of vaginal vault prolapse

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
Javed Iqbal ◽  
Fauzia Nausheen ◽  
Fozia Ali Bhatti ◽  
Arif Tajammul Khan ◽  
Shahida Sheikh
Keyword(s):  
Operation Time ◽  
Abdominal Hysterectomy ◽  
Vaginal Vault Prolapse ◽  
Vaginal Vault ◽  
Vault Prolapse ◽  
Abdominal Sacrocolpopexy ◽  
Estimated Blood Loss ◽  
One Year ◽  
Study Setting

Aims & Objectives: To review the efficacy of Sacrocolpopexy in the management of vaginal vault prolapse Study Design: Interventional study. Setting & Population: Department of Obstetrics & Gynaecology, Jinnah Hospital, Lahore. Women with vaginal vault prolapse after hysterectomy. Methods and Main-outcome measures: Abdominal Sacrocolpopexy using proline mesh. Follow-up in these patients were carried out at one week, four weeks, six months, and one year. Results: Sacrocolpopexy was carried out in ten patients for vaginal vault prolapse after vaginal (6) and abdominal hysterectomy (4). The mean age was 49.8 years. Parity was between P3 - P6 (Mean parity 4.3). Mean operation time was 79.3 minutes. Estimated blood loss was less than 200m1. No intra-operative or post-operative complications occurred in any case. Conclusion: Abdominal sacrocolpopexy is effective and safe in the treatment of vaginal vault prolapse. This procedure has high success rate in correcting prolapse without a time dependent decrease in efficacy.

scholarly journals Outcome of Abdominal Sacrocolpopexy for Post Hysterectomy Vaginal Vault Prolapse

2017 ◽  
Vol 31 (2) ◽  
pp. 90-93
Author(s):  
Liza Chowdhury ◽  
Nurun Nahar Khanam ◽  
Junnu Rayen Janna
Keyword(s):  
Postoperative Complications ◽  
Prospective Study ◽  
Synthetic Mesh ◽  
Vaginal Vault Prolapse ◽  
Vaginal Vault ◽  
Anterior Longitudinal Ligament ◽  
Vault Prolapse ◽  
Patients Satisfaction ◽  
Abdominal Sacrocolpopexy

Objective (s): The aim of this study was to explore the outcome of abdominal sacrocolpopexy for the correction of post hysterectomy vaginal vault prolapse.Materials and Methods: This prospective study was done over the period of five years from 2011 to 2015 where twenty patients of vault prolapse were subjected to abdominal sacrocolpopexy. Procedure was completed by securing the vaginal apex to the anterior longitudinal ligament of sacrum using synthetic mesh. Intra and postoperative complications and patients’ satisfaction was assessed.Results: No post-operative serious complications were reported during follow up period. The vaginal vault was well supported in all patients with no recurrent vault prolapse. One patient had mild asymptomatic rectocele. No mesh complication was found during the follow up period.Conclusion: The abdominal sacrocolpopexy achieves excellent correction of post hysterectomy vaginal vault prolapse with minimal morbidity.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 90-93

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.

Sacrocolpopexy for posthysterectomy vaginal vault prolapse: long-term follow-up

2016 ◽  
Vol 27 (10) ◽  
pp. 1563-1569 ◽  
Author(s):  
Ester Illiano ◽  
Konstantinos Giannitsas ◽  
Alessandro Zucchi ◽  
Manuel Di Biase ◽  
Michele Del Zingaro ◽  
...  
Keyword(s):  
Vaginal Vault Prolapse ◽  
Vaginal Vault ◽  
Vault Prolapse ◽  
Long Term Follow Up ◽  
Posthysterectomy Vaginal Vault Prolapse

scholarly journals Vaginal Vault Prolapse

2009 ◽  
Vol 2009 ◽  
pp. 1-9 ◽  
Author(s):  
Azubuike Uzoma ◽  
K. A. Farag
Keyword(s):  
Negative Impact ◽  
Surgical Techniques ◽  
Aging Population ◽  
Vaginal Vault Prolapse ◽  
Vaginal Vault ◽  
Clear Understanding ◽  
Vault Prolapse ◽  
Ureteric Injury ◽  
Sacrospinous Fixation ◽  
Abdominal Sacrocolpopexy

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.

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

2017 ◽  
Vol 66 (1) ◽  
pp. 46-55
Author(s):  
Dmitry D Shkarupa ◽  
Alexandr A Bezmenko ◽  
Nikita D Kubin ◽  
Ekaterina A Shapovalova ◽  
Alexey V Pisarev
Keyword(s):  
Surgical Treatment ◽  
De Novo ◽  
Uterine Prolapse ◽  
Operation Time ◽  
Vaginal Wall ◽  
Vaginal Vault Prolapse ◽  
Vaginal Vault ◽  
Vault Prolapse ◽  
Sacrospinous Fixation ◽  
Apical Sling

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.

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