title: Vaginal sacrocolporectopexy for the surgical treatment of uterine and vaginal vault prolapses: confirmation of the surgical method and perioperative results of 101 cases.
abstract: OBJECTIVE
  In this study, we sought to confirm the surgical method of vaginal sacrocolporectopexy and previously reported positive perioperative results of this procedure in a large patient group. We describe the approach which offers a vaginal, safe alternative to sacrospinous repair, laparoscopic or open vaginosacropexy and the use of synthetic meshes to treat pelvic organ prolapse.
  
  
  METHODS
  We conducted a monocentric, prospective, nonrandomized study for treatment of patients with uterine and vaginal vault relapse (grade 2-4). All patients underwent a preoperative urogynecological urodynamic examination. We focus on method, operative time, complications, blood transfusions, hospital stay and clinical data.
  
  
  RESULTS
  Between March 2006 and March 2011, 101 consecutive patients of mean age 64 (40-89) years, with sub or total uterine prolapse (n=69, grade 2-4) and vaginal vault prolapse (n=32, grade 2-4) were treated with vaginal sacrocolporectopexy. Cystocele (grade 2-4) was found in 88 (87.1%) and rectocele (grade 2-4) in 43 (42.5%) patients. Mean duration of surgery with sacrocolporectopexy was 70 min (28-165) without hysterectomy, and 76 min (40-219) with hysterectomy. Regression analysis of all patients (n=101) showed a significant decrease of operative time in the group without hysterectomy after 40 cases. Three bladder lesions, two in patients with a history of hysterectomy, occurred during surgery and were corrected intraoperatively without further complications. No patient required a blood transfusion. Hemoglobin levels decreased slightly from a preoperative mean of 13.6 mg/dl (10.3-15.7) to a postoperative mean of 11.7 mg/dl (8.6-14.7).
  
  
  CONCLUSIONS
  Vaginal sacrocolporectopexy is a safe vaginal method for the treatment of sub-/total uterine/vaginal vault prolapse.
authors.affiliation: Clinic for Obstetrics and Gynecology, Medical University of Hannover, Carl-Neubergstr. 1, 30625, Hannover, Germany. hertel.hermann@mh-hannover.de
authors.forename: Hermann
authors.initials: H
authors.lastname: Hertel
authors.forename: Susanne
authors.initials: S
authors.lastname: Grüßner
authors.forename: Stylianos
authors.initials: S
authors.lastname: Kotsis
authors.forename: Peter
authors.initials: P
authors.lastname: Hillemanns
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D001803:Blood Transfusion; D052858:Cystocele / Q000150:complications / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007044:Hysterectomy; D007902:Length of Stay; D017846:Longitudinal Ligaments / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D010052:Ovariectomy; D020047:Rectocele / Q000150:complications / Q000601:surgery; D058994:Salpingectomy; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*; D014621:Vagina / Q000601:surgery*