Recurrent prolapse after sacrocolpopexy for post-hysterectomy vaginal vault prolapse.
This study looked at the subjective and objective long-term outcome of abdominal sacrocolpopexy for post-hysterectomy vaginal vault prolapse, with emphasis on recurrent prolapse. It included 42 patients who had abdominal sacrocolpopexy for post-hysterectomy vaginal vault prolapse from 1994 to 2004. Patients were invited for a follow-up visit to assess the objective and subjective outcome. The notes of 35 patients (83.3%) were available and 22 attended for follow-up (52.4%). None of them had a recurrent vault prolapse (0% direct failure rate). However, 20 cases (20%) had a repair operation by the time they were invited for follow-up and 18 of those attending for follow-up had anterior and/or posterior vaginal wall prolapse (81.8% indirect failure rate). Nonetheless, only eight of these (44.4%) were symptomatic, bringing the rate of indirect recurrences requiring management to 50%. Concomitant or prior repair operation was associated with a lower incidence of indirect recurrence. The incidence of urodynamic stress incontinence and detrusor overactivity was 13.6% and bowel emptying dysfunction was 4.5%.
Ismail
S I M F
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Department of Obstetrics and Gynaecology, Wrexham Maelor Hospital, Wrexham, Wales, UK. sharif212121@yahoo.co
D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods*; D014596:Uterine Prolapse / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D014852:Wales / Q000453:epidemiology