Perioperative course and long term outcome after vaginal sacrospinous colpopexy for vaginal vault prolapse post hysterectomy: comparison of three different suture methods.
OBJECTIVE
To compare long-term results of the vaginal sacrospinous colpopexy (VSC) procedure for the treatment of vaginal vault prolapse after previous hysterectomy with the use of either of the three most commonly used devices (the Deschamps ligature carrier, the Shutt Suture Punch System, or an ordinary straight needle holder).


METHODS
The study group consisted of 73 women (out of 84; response rate 86%) who had undergone VSC for vaginal vault prolapse in between January 1994 and April 2005. All these patients were contacted with a mailed questionnaire and asked about symptoms related to prolapse, possible complications, any subsequent surgical repair and their satisfaction with results of the surgery. All data concerning the patients' characteristics at the time of surgery and perioperative events were retrospectively collected using the patient records (charts).


RESULTS
There were no significant differences in age, parity, body mass index, or in proportion of previous prolapse or incontinence surgery between groups. The operation time was similar in all groups, with a median duration around 60 min. There was a wide distribution of the estimated blood loss in the groups, but without significant differences between groups. The rate of complications was low in all groups. Most of the patients were 'very satisfied' with the results of the surgery and rated their satisfaction as 8 to 10. The proportions of patients being very satisfied with the results of the surgery were 84%, 80% and 87% in the Deschamps, Shutt and needle holder groups, respectively.


CONCLUSIONS
In the present study we could not see any major differences in perioperative data when comparing usage of the three instruments. Operation time, complications rate, perioperative blood loss and the patient's satisfaction with the surgery were equal between the three groups. This indicates that the type of instrument used in VSC is of no importance.
Marcickiewicz
Janusz
J
Department of Obstetrics and Gynecology, The Sahlgrenska Academy at Göteborg University, Sweden. janusz.marcickiewicz@obgyn.gu.se
Kjöllesdal
Möyfrid
M
Brännström
Mats
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003127:Colposcopy / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*