Sexual function after sacrospinous fixation for vaginal vault prolapse: bad or mad?
BACKGROUND
The main indication for sacrospinous ligament suspension is to correct either total procidentia, a posthysterectomy vaginal vault prolapse with an associated weak cardinal uterosacral ligament complex, or a posthysterectomy enterocele. This study aimed to evaluate sexual function and anatomic outcome for patients after sacrospinous ligament suspension.


METHODS
For this study, 52 patients who had undergone sacrospinous ligament fixation during the preceding 5 years were asked to complete the Female Sexual Function Index (FSFI) questionnaire. The patients were vaginally examined using the ICS POP score, and the results were compared with their preoperative status. For statistical analysis, GraphPad for Windows, version 4.0, was used.


RESULTS
The 52 patients were examined during a follow-up period of 38 months. No major intraoperative complications were noted. Recurrence of symptomatic apical descent was noted in 6% of the patients and de novo prolapse in 13.5%. Only one patient was symptomatic. Three patients experienced de novo dyspareunia, which resolved in two cases after stitch removal. Sexual function was good, rating higher than three points for each of the domains including satisfaction, lubrication, desire, orgasm, and pain.


CONCLUSIONS
Sacrospinous ligament fixation still is a valuable option for the treatment of vaginal vault prolapse. Sexual function is satisfactory, with few cases of de novo dyspareunia.
Baumann
Marc
M
Department of Obstetrics and Gynaecology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Salvisberg
Claudia
C
Mueller
Michel
M
Kuhn
Annette
A
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D014596:Uterine Prolapse / Q000601:surgery*