title: [Study on ischiospinous ligament fixation in treatment of stage III pelvic organ prolapse].
abstract: OBJECTIVE
  To evaluate the safety and efficacy of ischiospinous ligament fixation in treatment of stage III pelvic organ prolapse (POP).
  
  
  METHODS
  Between March 2007 and December 2009, 65 patients with stage III POP who underwent ischiospinous ligament fixation in Peking Union Medical College Hospital were enrolled in this study. Among 21 cases complicated with stress urinary incontinence (SUI) underwent transobturator tension-free vaginal tape (TVT-O) concomitantly. Clinical parameter associated with perioperation, objective and subjective successful rate and complication were recorded.
  
  
  RESULTS
  The mean operating time was (71 ± 22) min and the mean blood loss was (93 ± 40) ml. No intraoperative blood transfusion and viscera injury cases were observed. All patients were able to recover spontaneous micturition. Two cases experienced pelvic hematoma with diameter of 7 cm, after conservative treatment, they all recovered later. The objective success rate was 100% at 6 weeks follow-up by POP-Q scoring. And 46.2% (30/65) were followed up at range of 1 - 3 years, recurrence rate were 10% (3/30), and however, no operation were needed. At median of 20 months, all patients were followed up by telephone, the subjective successful rate was 95.4% (62/65). At 6 weeks after operation, 6.2% (4/65) patients suffered from lower back pain and right thigh pain, visual analogue scale of pain was at range of 3 to 5, which relieved gradually after treatment and disappeared totally within 2 years. The rate of suture exposure was 10% (3/30), the new urinary incontinence 4.6% (3/65), and the new dyspareunia 12.5% (3/24).
  
  
  CONCLUSIONS
  Ischiospinous ligament fixation is a safe and efficacious management.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.forename: Lan
authors.initials: L
authors.lastname: Zhu
authors.forename: Jing-he
authors.initials: JH
authors.lastname: Lang
authors.forename: Hong-hui
authors.initials: HH
authors.lastname: Shi
authors.forename: Zhi-jing
authors.initials: ZJ
authors.lastname: Sun
authors.forename: Xiao-ming
authors.initials: XM
authors.lastname: Gong
mesh_terms: D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007045:Hysterectomy, Vaginal; D007512:Ischium; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D053825:Suburethral Slings; D013536:Suture Techniques; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery; D014563:Urodynamics; D014621:Vagina / Q000601:surgery*