title: Bilateral sacrospinous vault fixation with tailored synthetic mesh arms: clinical outcomes at one year.
abstract: OBJECTIVE
  Bilateral sacrospinous fixation with tailored mesh arms (bSSVF) uses polypropylene mesh to suspend the vault to the sacrospinous ligaments bilaterally with minimal tension, recreating nulliparous midline anatomy. It can be used with uterine conservation. Our primary objective was to determine objective cure rate at one year following bSSVF compared with a control group undergoing abdominal sacrocolpopexy (ASC). Secondary objectives were to compare symptoms, quality of life, sexual function, pain, and global satisfaction before and after surgery and between bSSVF and ASC groups at one year.
  
  
  METHODS
  This prospective cohort study enrolled patients with symptomatic prolapse who chose to undergo bSSVF or ASC. Baseline demographics were obtained. Prolapse quantification, validated symptom questionnaire scores, and McGill pain scores were obtained at baseline, six weeks, and one-year postoperatively. Global satisfaction was recorded. The primary outcome measure was the difference in cure rate (vault stage ≤ 1) between groups.
  
  
  RESULTS
  Fifty patients were recruited: 30 underwent bSSVF and 17 ASC. Forty-three patients were available for one-year follow-up. Baseline data were similar. There was no difference in vault stage between bSSVF and ASC groups at one year. Five women who underwent bSSVF had cervical elongation, and four of these were classified as POP recurrence. Women who underwent bSSVF had more anterior recurrences but fewer postoperative complications, shorter hospital stay, and less use of narcotics than controls. Questionnaire scores were similar at one year. All respondents felt subjective improvement after either surgical procedure.
  
  
  CONCLUSIONS
  Objective and subjective cure rates are comparable after bSSVF and ASC. Hysteropexy may cause cervical elongation that merits further research.
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Roxana
authors.initials: R
authors.lastname: Geoffrion
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Momoe T
authors.initials: MT
authors.lastname: Hyakutake
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Koenig
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Terry
authors.initials: T
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Geoffrey W
authors.initials: GW
authors.lastname: Cundiff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
keywords: bilateral sacrospinous fixation; pelvic organ prolapse; synthetic mesh