title: Pectineal ligament suspension of prolapsed vaginal vault.
abstract: OBJECTIVE
  To report on a collective pectineal ligament suspension experience acquired over 12 years in India with 119 women who presented with prolapsed vaginal vault. The feasibility and effectiveness of the procedure was assessed for the open and laparoscopic routes.
  
  
  METHODS
  The prolapsed vaginal vault was suspended unilaterally to the pectineal ligament using polyester tape at 3 urban and 3 rural hospitals. The procedure was done through a Cherney incision in 104 women. In the remaining 15 women, it was done laparoscopically at a single urban center.
  
  
  RESULTS
  There were no intraoperative complications. The mean follow-up was 5.5 years (range, 0.5-12 years). Only 2 women had vaginal prolapse recurrence, at 3 and 5 years. Two had asymptomatic tape erosion, at 2 and 5 years, and a mild cystocele appeared in 5 women and a low rectocele in 4. However, none of these women required further vaginal surgery during their follow-up period.
  
  
  CONCLUSIONS
  The present study demonstrates the long-term safety and effectiveness of pectineal ligament suspension for vaginal vault prolapse by the open and the laparoscopic routes. As it was done by surgeons of varying experience at centers with varying resources, the procedure can be readily mastered by any gynecologic surgeon.
authors.affiliation: Department of Obstetrics and Gynecology, KEM Hospital, Pune, India. Electronic address: drvivek_joshi@yahoo.co.in.
authors.forename: Vivek M
authors.initials: VM
authors.lastname: Joshi
authors.forename: Suhas R
authors.initials: SR
authors.lastname: Otiv
authors.forename: Vasant B
authors.initials: VB
authors.lastname: Dagade
authors.forename: Mahindra
authors.initials: M
authors.lastname: Borse
authors.forename: Rabin N
authors.initials: RN
authors.lastname: Majumder
authors.forename: Maneesha
authors.initials: M
authors.lastname: Shrivastava
authors.forename: Ravindra
authors.initials: R
authors.lastname: Shelmohkar
authors.forename: Smita
authors.initials: S
authors.lastname: Bijwe
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007194:India; D010535:Laparoscopy / Q000379:methods*; D008022:Ligaments; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012008:Recurrence; D019035:Rural Health Services; D053832:Surgical Tape; D016896:Treatment Outcome; D019037:Urban Health Services
keywords: Colpopexy; Laparoscopic; Pectineal ligament; Vaginal vault prolapse