Transvaginal sacrospinous colpopexy for vault and marked uterovaginal prolapse.
OBJECTIVE
To assess the results of the sacrospinous colpopexy procedure for the treatment of vault prolapse following hysterectomy and marked uterovaginal prolapse.


METHODS
A prospective study of all patients undergoing sacrospinous colpopexy for vault and marked uterovaginal prolapse between December 1991 and December 1992.


METHODS
Kent and Canterbury Hospital, Canterbury.


METHODS
Forty women with vault prolapse following hysterectomy and 24 with marked uterovaginal prolapse.


METHODS
All patients underwent posterior vaginal repair, enterocele sac obliteration and sacrospinous colpopexy. In 48 patients an anterior vaginal repair with suburethral buttressing sutures was also performed. A long-needle bladder neck suspension operation (Raz procedure) was included for three women with coexistent stress incontinence. In 13 patients a vaginal hysterectomy was performed and in 11 the uterus was conserved. A postanal sacrorectopexy was performed on one patient with marked rectal prolapse.


RESULTS
The mean follow up period was five months. So far, there have been three failures in the group treated for vault prolapse. One of these underwent a successful repeat sacrospinous colpopexy and repair. The main long term complication was cystocele formation. One sexually active patient complained of dyspareunia following surgery.


CONCLUSIONS
The sacrospinous colpopexy is effective in the treatment of vault prolapse and compares favourably with abdominal vault supporting procedures. It avoids major abdominal surgery and allows the surgeon to correct coexistent cystocele and rectocele. This procedure is also a useful adjuvant when treating marked uterovaginal prolapse.
Department of Obstetrics and Gynaecology, Kent and Canterbury Hospital.
M P
MP
Carey
M C
MC
Slack
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D005500:Follow-Up Studies; D006176:Gynecology / Q000379:methods; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008875:Middle Aged; D011446:Prospective Studies; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000209:etiology / Q000601:surgery*; D014621:Vagina / Q000601:surgery*