Outcomes study: A comparison of cure rates in 695 patients undergoing sacrospinous ligament fixation alone and with other site-specific procedures--a 16-year study.
OBJECTIVE
The study was undertaken to compare the results of vaginal fixation from a time when sacrospinous ligament fixation (SSLF) was performed solely or with minimal repair of other defects with the results of SSLF when site-specific defect approaches were performed.


METHODS
Six hundred ninety-five patients underwent an SSLF over a 16-year period. From 1985 through 1990, minimal attention was paid to other sites because the SSLF appeared to correct all vaginal tract defects (group A = 173). From 1991 through 1994, we realized that our attempts were failing. An anterior and posterior colporrhaphy, and a high ligation of any cul-de-sac were performed when appropriate (group B = 221). From 1995 through 2000, site-specific repairs of all defects were used to care for these patients with prolapse (group C = 301).


RESULTS
The anatomic cure rates for the SSLF (when evaluating only the vaginal apex) were calculated for vault fixation. When site-specific repairs were used and all sites repaired anatomically (group C), cure predominated. The chi(2) calculations for group A compared with group B and group B compared with group C were performed.


CONCLUSIONS
The SSLF technique is still a good option for apical prolapse, does not have to distort the vaginal axis, and is to be used in conjunction with other site-specific repairs.
Cruikshank
Stephen H
SH
Michigan State University Schoof of Medicine, Lansing, USA. brttmrc@aol.com
Muniz
Margo
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods / Q000592:standards; D006801:Humans; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D009505:Nevada; D011183:Postoperative Complications; D020047:Rectocele; D012086:Reoperation; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014549:Urinary Incontinence; D014596:Uterine Prolapse / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000002:abnormalities / Q000601:surgery