Clinical outcome of sacrospinous fixation following pelvic organ prolapse surgery

Aims: To evaluate the midterm outcome of sacrospinous fixation done during surgical management of pelvic organ prolapse. Methods: This was an interview based cross sectional follow up study done among the patients who underwent sacrospinous fixation procedure along with pelvic organ prolapse surgery in Kathmandu Model Hospital and Paropakar Maternity Hospital. This was conducted between 15 th February 2021 and 15 th April 2021. Post-operative cases 22 to 30 months (average 2 years) from the day of surgery were included. Results: Out of 321 eligible SSF patients from both the hospital, 156 agreed to participate. Among them, 77 (48%) were in 60-69 years of age and 82% were postmenopausal; 33% were more than para 3; 20% had right gluteal pain that was decreased to 1.9% by 2 years; and 20% had some degree of urgency and stress incontinence. Conclusion: Sacrospinous fixation is safe and effective procedure which can be done during pelvic organ prolapse surgery with good success rate and minimal post-operative complications.

Bladder rupture due to urogenital tract trauma caused by ox horn injury in a patient with pelvic organ prolapse: a case report

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.