Long-term outcome of vaginal sacrospinous colpopexy for marked uterovaginal and vault prolapse.
BACKGROUND
This study was carried out to evaluate the safety and long-term outcome of sacrospinous colpopexy in marked genital prolapse.


METHODS
Gynaecology Department, Benenden Hospital, Kent, UK.


METHODS
A prospective observational study was conducted between September 1993 and May 2000 on 305 women who underwent transvaginal sacrospinous colpopexy. The indications for surgery were marked vault prolapse in 43% and uterovaginal prolapse or enterocele in 57%. Patient follow up was at 6 weeks, 6 months, 1 year and then annually. Data was collected prospectively at the time of initial recruitment, during hospital stay and at the end of each follow up visit.


RESULTS
Hysterectomy was performed in 117 patients and anterior colporrhaphy in 182. The mean operative time for the entire surgery was 65.6 min (S.D. 27.4, range 20-160 min) and estimated blood loss was 81.8 ml (S.D. 92, range 20-800 ml). After a mean follow up period of 57 months (range 24-84), vault support was maintained in 96%; recurrent vault prolapse occurred in 12 patients (4%) and the mean vaginal length at 1 and 5 years of follow up was 8+/-0.9 and 7.8+/-1.2 cm. Symptomatic cystocele occurred in 15 patients (5%). There were six recurrences of rectocele (2%) and there was no enterocele recurrence. Sexual function was maintained in all sexually active women and 43% reported improvement in sexual function. Out of 14 women who complained of fecal incontinence, 10 (71%) reported cure and 3 (21%) improved after surgery.


CONCLUSIONS
Vaginal sacrospinous colpopexy is associated with a high long-term success rate in correcting upper genital prolapse.
Hefni
Mohamed A
MA
Gynaecology Department, Benenden Hospital, Benenden, Kent TN17 4AX, UK. mhefni@benenden.org.uk
El-Toukhy
Tarek A
TA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D003127:Colposcopy / Q000379:methods*; D005242:Fecal Incontinence / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery*