Infracoccygeal sacropexy or sacrospinous suspension for uterine or vaginal vault prolapse.
OBJECTIVE
To compare infracoccygeal sacropexy (IS) and sacrospinous suspension (SS) for the treatment of uterine or vault prolapse.


METHODS
A randomized trial of 49 women assigned to either the IS group using IVS tape (n=24) or SS group (n=25). Concomitant hysterectomy and repairs were performed as appropriate. Evaluations included prolapse staging using the POP-Q system and validated questionnaires for symptoms (PFDI), quality of life (PFIQ), and sexuality (PISQ-12). The primary outcome measure was postoperative pain.


RESULTS
Patients' characteristics were similar in both groups. IS was quicker, easier, and less painful than SS (P<0.01). Hemorrhage or hematoma rates were similar. Neither rectal injury nor vaginal erosion occurred. Mean follow-up was 16.8 months. Prolapse cure rates, symptom scores, and quality of life were similar. Postoperative cystocele occurred in 4.8% of women after IS and 25% after SS (P>0.05).


CONCLUSIONS
Infracoccygeal sacropexy is equivalent to sacrospinous suspension, with a decreased rate of postoperative pain and cystocele recurrence.
de Tayrac
R
R
Department of Obstetrics and Gynecology, Caremeau Hospital, Nimes, France. renaud.detayrac@chu-nimes.fr
Mathé
M-L
ML
Bader
G
G
Deffieux
X
X
Fazel
A
A
Fernandez
H
H
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain; D017060:Patient Satisfaction; D011788:Quality of Life; D055502:Secondary Prevention; D053825:Suburethral Slings / Q000009:adverse effects*; D014596:Uterine Prolapse / Q000601:surgery*