title: Risk factors of surgical failure following sacrospinous colpopexy for the treatment of uterovaginal prolapse.
abstract: OBJECTIVE
  Trans-vaginal sacrospinous colpopexy is one of the surgical procedures used to repair varying degrees of vaginal vault and uterovaginal prolapse. The purpose of this study is to analyse the potential risk factors of surgical failure following sacrospinous colpopexy.
  
  
  METHODS
  A retrospective study of 114 women who underwent unilateral sacrospinous colpopexy at Jordan University Hospital from January 2005 to January 2008 were included. Patient demographics, clinical characteristics and concomitant pelvic organ prolapse surgery were assessed. The patients were evaluated at 6 weeks, and every 6 months thereafter. Twelve (11 %) had recurrent apical (vaginal cuff) prolapse, 26 (23 %) had recurrent prolapse at any compartment were compared with those who had successful surgery. Univariate and logistic regression analyses were used to assess the independent prognostic values of the variables associated with surgical failure.
  
  
  RESULTS
  After a mean follow-up of 40 months, the statistically significant predictors of surgical failure included the presence of advanced pre-operative stages of prolapse (stages III and IV), the more distally located points Ba, Bp and C and a lack of mesh augmentation of the anterior vaginal wall during surgery (P = 0.01, 0.027, 0.024, 0.034 and 0.006, respectively). However, a history of prior vaginal repair, the more distally located point Ba and a lack of anterior vaginal wall mesh augmentation were defined as independent predictive variables based on logistic regression analyses (P = 0.04, 0.005 and 0.046, respectively).
  
  
  CONCLUSIONS
  The presence of advanced anterior vaginal wall prolapse, prior vaginal repair and a lack of mesh augmentation of the anterior compartment are significant risk factors for the surgical failure of sacrospinous suspension surgery.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of Jordan, PO Box 2289, Amman 11910, Jordan. aymenfida@yahoo.com
authors.forename: Ayman
authors.initials: A
authors.lastname: Qatawneh
authors.forename: Fida
authors.initials: F
authors.lastname: Thekrallah
authors.forename: Majed
authors.initials: M
authors.lastname: Bata
authors.forename: Fawaz
authors.initials: F
authors.lastname: Al-Kazaleh
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Almustafa
authors.forename: Ilham
authors.initials: I
authors.lastname: Abu-Kader
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007597:Jordan; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013526:Surgical Mesh; D017211:Treatment Failure; D014596:Uterine Prolapse / Q000601:surgery*