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Sacrospinous suspension: A local practitioner's experience

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      Abstract

      OBJECTIVE: The objective of the study was to determine the effectiveness of transvaginal sacrospinous fixation of the vaginal vault as part of the total pelvic reconstructive surgery performed for patients with uterovaginal prolapse and vaginal vault prolapse.
      STUDY DESIGN: The hospital and office records of 156 patients undergoing sacrospinous suspension of the vaginal vault between Sept. 14, 1987, and March 22, 1994, were retrospectively reviewed. The preoperative pelvic support defects were compared with the postoperative pelvic support defects. The proportion test for independent samples was used to determine statistical significance.
      RESULTS: Eight (5.6%) patients have had recurrence of vaginal vault prolapse, with two of these patients having undergone repeat pelvic reconstructive surgery. Eleven (7.6%) patients have had recurrent anterior segment defects, whereas two (1.4%) patients have had recurrent posterior segment defects.
      CONCLUSION: Ninety-four percent of the patients who underwent sacrospinous suspension for uterovaginal prolapse and vaginal vault prolapse have had no persistence or recurrence of vaginal vault prolapse 6 to 83 months after the procedure.

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      References

        • DeLancey JOL
        Anatomy and biomechanics of genital prolapse.
        Clin Obstet Gynecol. 1993; 36: 897-909
        • Symmonds RE
        • Williams TJ
        • Lee RA
        • Webb MJ
        Posthysterectomy enterocele and vaginal vault prolapse.
        Am J Obstet Gynecol. 1981; 140: 852-859
        • Seigworth GR
        Vaginal vault prolapse with eversion.
        Obstet Gynecol. 1979; 54: 255-260
        • Thornton WN
        • Peters WA
        Repair of vaginal prolapse after hysterectomy.
        Am J Obstet Gynecol. 1983; 147: 140-148
        • Richter K
        • Albrich W
        Long-term results following fixation of the vagina on the sacrospinal ligament by the vaginal route.
        Am J Obstet Gynecol. 1981; 141: 811-816
        • Nichols DH
        Sacrospinous fixation for massive eversion of the vagina.
        Am J Obstet Gynecol. 1982; 142: 901-904
        • Moreley GW
        • DeLancey JOL
        Sacrospinous, ligament fixation for eversion of the vagina.
        Am J Obstet Gynecol. 1988; 158: 872-881
        • Inmon WB
        Pelvic relaxation and repair including prolapse of vaginal following hysterectomy.
        South Med J. 1963; 56: 577-582
        • Shull BL
        • Capen CV
        • Riggs MW
        • Kuehl TJ
        Bilateral attachment of the vaginal cuff to iliococcygeus fascia: an effective method of cuff suspension.
        Am J Obstet Gynecol. 1993; 168: 1669-1677
        • Morley GW
        Vaginal approach to treatment of vaginal vault eversion.
        Clin Obstet Gynecol. 1993; 36: 984-994
        • Timmons MC
        • Addison WA
        • Addison SB
        • Cavenar MG
        Abdominal sacral colpopexy in 163 women with posthysterectomy vaginal vault prolapse and enterocele.
        J Reprod Med. 1992; 37: 323-327
        • Randall CL
        • Nichols DH
        Surgical treatment of vaginal inversion.
        Obstet Gynecol. 1971; 38: 327-332
        • Shull BL
        Clinical evaluation of women with pelvic support defects.
        Clin Obstet Gynecol. 1993; 36: 939-951
        • Porges RF
        A practical system of diagnosis and classification of pelvic relaxation.
        Surg Gynecol Obstet. 1963; 117: 769-773
        • Lee RA
        Vaginal hysterectomy with repair of enterocele, cystocele, and rectocele.
        Clin Obstet Gynecol. 1993; 36: 967-975
        • Pasley WW
        Trachelectomy: a review of 55 cases.
        Am J Obstet Gynecol. 1988; 159: 728-732
        • McCall ML
        Posterior culdeplasty.
        Obstet Gynecol. 1957; 10: 595-602
        • DeLancey JOL
        Anatomic aspects of vaginal eversion after hysterectomy.
        Am J Obstet Gynecol. 1992; 166: 1717-1728
        • White GR
        An anatomical operation for the cure of cystocele.
        Am J Obstet Dis Wom Child. 1912; 65: 286-290
        • Richardson AC
        • Lyon JB
        • Williams NL
        A new look at pelvic relaxation.
        Am J Obstet Gynecol. 1976; 128: 568-573
        • Richardson AC
        The rectovaginal septum revisited: its relation to rectocele and its importance in rectocele repair.
        Clin Obstet Gynecol. 1993; 36: 976-983
        • Nichols DH
        • Milley PS
        • Randall CL
        Significance of restoration of normal vaginal depth and axis.
        Obstet Gynecol. 1970; 36: 251-256
        • Shull BL
        • Capen CV
        • Riggs MW
        • Kuehl TJ
        Preoperative and postoperative analysis of site-specific pelvic support defects in 81 women treated with sacrospinous suspension and pelvic reconstruction.
        Am J Obstet Gynecol. 1992; 166: 1764-1771
        • Bonney V
        The principles that should underlie all operations for prolapse.
        J Obstet Gynecol Br Emp. 1934; 41: 669-683

      References

        • Cruikshank SH
        Operations for support of the vaginal vault.
        in: Sciarra JJ Droegemueller W Gynecology and obstetrics. JB Lippincott, Philadelphia1994: 1-9
        • Morley GW
        Vaginal approach to treatment of vaginal vault eversion.
        Clin Obstet Gynecol. 1993; 36: 984-994
        • Carey MD
        • Slack MC
        Transvaginal sacrospinous colpopexy for vault and marked uterovaginal prolapse.
        Br J Obstet Gynaecol. 1994; 101: 536-540
        • Valaitis DR
        • Stanton SL
        Sacrocolpopexy a retrospective study of a clinician's experience.
        Br J Obstet Gynaecol. 1994; 101: 518-522
        • Heinoven PK
        Transvaginal sacrospinous colpopexy for vaginal vault and complete genital prolapse in aged women.
        Acta Obstet Gynecol Scand. 1992; 71: 377-381
        • Timmons MC
        • Addison WA
        • Addison SB
        • Cavenar MG
        Abdominal sacral colpopexy in 163 women with posthysterectomy vaginal vault prolapse and enterocele.
        J Reprod Med. 1992; 37: 323-327
        • Symmonds RE
        • Williams TJ
        • Lee RA
        • Webb MJ
        Posthysterectomy enterocele and vaginal vault prolapse.
        Am J Obstet Gynecol. 1981; 140: 852-859
        • Morley GW
        • DeLancey JOL
        Sacrospinous ligament fixation for eversion of the vagina.
        Am J Obstet Gynecol. 1988; 158: 872-881
        • Cruickshank SH
        • Cox DW
        Sacrospinous ligament fixation at the time of transvaginal hysterectomy.
        Am J Obstet Gynecol. 1990; 162: 1611-1615
        • Cruickshank SH
        Prevention of posthysterectomy vaginal vault prolapse and enterocele during vaginal hysterectomy.
        Am J Obstet Gynecol. 1987; 156: 1433
        • Dorsey JH
        • Cundiff G
        Laparoscopic procedures for incontinence and prolapse.
        Curr Opin Obstet Gynecol. 1994; 6: 223-230
        • Nezhat CN
        • Nezhat F
        • Nezhat C
        Laparoscopic sacral colpopexy for vaginal vault prolapse.
        Obstet Gynecol. 1994; 84: 885-888

      References

        • Thornton WN
        • Peters WA
        Repair of vaginal prolapse after hysterectomy.
        Am J Obstet Gynecol. 1983; 147: 140-148