title: Longterm followup of posthysterectomy vaginal vault prolapse abdominal repair: a report of 85 cases.
abstract: BACKGROUND
  There are many surgical procedures to treat posthysterectomy vaginal vault prolapse. Abdominal sacral colpopexy is one of these procedures. The aim of this study was to review the cases of 85 consecutive patients treated by this technique since 1978 by the same surgical team using the same procedure. Our surgical procedure will be explained.
  
  
  METHODS
  Eighty-five patients were treated in our department between 1978 and 1998 for posthysterectomy vaginal vault prolapse. The mean age was 55.42 years. The mean weight was 63.37 kg. Their parity ranged from 0 to 5 (mean, 2.54). The interval of time between hysterectomy and vaginal vault prolapse repair ranged from 1 to 37 years (mean, 17.92 years). The main indication for hysterectomy was uterine leiomyomas. Of these patients, 67.05% had stress urinary incontinence, and mean urethral closure pressure was 48.7 cm H2O. All patients had abdominal sacral colpopexy associated with a Burch procedure and a posterior perineal repair.
  
  
  RESULTS
  Seventeen patients had postoperative fever. Twenty-two had urinary tract infections. Two patients had to undergo blood transfusion. Three patients had postoperative urinary retention. The median longterm followup was 10.5 years; 27.05% of patients had relapsing stress urinary incontinence. Two patients had a relapse of the vaginal vault prolapse.
  
  
  CONCLUSIONS
  The abdominal sacral colpopexy is a safe operation with low morbidity and long-standing good results. It can be recommended for sexually active women. Nevertheless, the Burch procedure performed with this operation failed to prevent recurrence of urinary incontinence.
authors.affiliation: Department of Gynecologic Surgery, Salpétrière University Hospital, Assistance Publique-Hĵpitaux de Paris, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lefranc
authors.forename: David
authors.initials: D
authors.lastname: Atallah
authors.forename: Sophie
authors.initials: S
authors.lastname: Camatte
authors.forename: Jean
authors.initials: J
authors.lastname: Blondon
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000209:etiology* / Q000601:surgery*