Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study.
OBJECTIVE
The purpose of this study was to compare the abdominal sacral colpopexy and vaginal sacrospinous colpopexy in the treatment of vaginal vault prolapse.


METHODS
Ninety-five women with vaginal vault prolapse were allocated randomly to sacral colpopexy (47 women) or sacrospinous colpopexy (48 women). Primary outcome measurements include subjective, objective, and patient-determined success rates. Secondary outcomes include the impact on bowel, bladder, and sexual function, cost, and quality of life.


RESULTS
Two years after the operation (range, 6-60 months), the subjective success rate was 94% in the abdominal and 91% in the vaginal group (P=.19). The objective success rate was 76% in the abdominal group and 69% in the vaginal group (P=.48). The abdominal approach was associated with a longer operating time, a slower return to activities of daily living, and a greater cost than the sacrospinous colpopexy (P<.01). Both surgeries significantly improved the patient's quality of life (P<.05).


CONCLUSIONS
Abdominal sacral colpopexy and vaginal sacrospinous colpopexy are both highly effective in the treatment of vaginal vault prolapse.
Maher
Christopher F
CF
Urogynaecology Unit, Royal Women's and Mater Hospitals, Brisbane, QLD, Australia. chrismaher@urogynaecology.com.au
Qatawneh
Aymen M
AM
Dwyer
Peter L
PL
Carey
Marcus P
MP
Cornish
Ann
A
Schluter
Philip J
PJ
D000005:Abdomen; D000203:Activities of Daily Living; D004414:Dyspareunia / Q000150:complications / Q000209:etiology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D017048:Health Care Costs; D006801:Humans; D011788:Quality of Life; D012074:Remission Induction; D012445:Sacrococcygeal Region; D012725:Sexual Behavior; D013526:Surgical Mesh; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*; D014621:Vagina