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Repair of recurrent vaginal vault prolapse using sacrospinous ligament fixation with mesh interposition and reinforcement.
Acta Obstet Gynecol Scand. 2005 Oct; 84(10):992-5.AO

Abstract

OBJECTIVE

Our goal was to study the efficacy of performing the repeated sacrospinous ligament fixation with mesh interposition and reinforcement in women with recurrent vaginal vault prolapse.

MATERIALS AND METHODS

Fifteen consecutive patients with symptomatic severe vaginal vault or uterus prolapse after previous sacrospinous ligament fixation were enrolled. The sacrospinous ligament fixation was performed with a mesh interposition between sacrospinous ligament complex and vaginal apex. The mesh was extended to anterior and posterior vaginal wall for the repair of concurrent cystocele and rectocele, if indicated. The surgical results and complications were evaluated. The prolapse evaluation was performed according to International Continence Society (ICS) ordinal stages of pelvic organ prolapse.

RESULTS

The mean age was 55 years. The mean follow-up was 2.9 years (range 1.0-5.5 years). Repeated sacrospinous ligament fixation was performed for all patients. Eleven were performed unilaterally to the right and four to the left. The average time for sacrospinous fixation was 20 min. The average blood loss for sacrospinous fixation was 75 ml. No major complication except one accidental rectotomy was observed. It was repaired intraoperatively without sequel. The concurrent pelvic surgeries included vaginal total hysterectomies, anterior colporrhaphies, posterior colporrhaphies, and tension-free vaginal tape procedures. No recurrence of apical prolapse was observed. However, two patients developed stage I prolapse on anterior vaginal wall (cystocele) and required no further repair. Minor postoperative complications were observed.

CONCLUSION

Repeated sacrospinous ligament fixation with mesh interposition and reinforcement is a safe and effective procedure for the correction of recurrent vault prolapse. The extended implanted mesh can be used for the repair of concurrent cystorectocele effectively. A long-term follow-up is necessary to detect any late complication.

Authors+Show Affiliations

Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Kwei-shan, Tao-Yuan Hsien, Taiwan, Republic of China. 2378@adm.cgmh.com.twNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

16167917

Citation

Lo, Tsia-Shu, et al. "Repair of Recurrent Vaginal Vault Prolapse Using Sacrospinous Ligament Fixation With Mesh Interposition and Reinforcement." Acta Obstetricia Et Gynecologica Scandinavica, vol. 84, no. 10, 2005, pp. 992-5.
Lo TS, Horng SG, Huang HJ, et al. Repair of recurrent vaginal vault prolapse using sacrospinous ligament fixation with mesh interposition and reinforcement. Acta Obstet Gynecol Scand. 2005;84(10):992-5.
Lo, T. S., Horng, S. G., Huang, H. J., Lee, S. J., & Liang, C. C. (2005). Repair of recurrent vaginal vault prolapse using sacrospinous ligament fixation with mesh interposition and reinforcement. Acta Obstetricia Et Gynecologica Scandinavica, 84(10), 992-5.
Lo TS, et al. Repair of Recurrent Vaginal Vault Prolapse Using Sacrospinous Ligament Fixation With Mesh Interposition and Reinforcement. Acta Obstet Gynecol Scand. 2005;84(10):992-5. PubMed PMID: 16167917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Repair of recurrent vaginal vault prolapse using sacrospinous ligament fixation with mesh interposition and reinforcement. AU - Lo,Tsia-Shu, AU - Horng,Shang-Gwo, AU - Huang,Huei-Jean, AU - Lee,Shu-Jane, AU - Liang,Ching-Chung, PY - 2005/9/20/pubmed PY - 2005/11/8/medline PY - 2005/9/20/entrez SP - 992 EP - 5 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 84 IS - 10 N2 - OBJECTIVE: Our goal was to study the efficacy of performing the repeated sacrospinous ligament fixation with mesh interposition and reinforcement in women with recurrent vaginal vault prolapse. MATERIALS AND METHODS: Fifteen consecutive patients with symptomatic severe vaginal vault or uterus prolapse after previous sacrospinous ligament fixation were enrolled. The sacrospinous ligament fixation was performed with a mesh interposition between sacrospinous ligament complex and vaginal apex. The mesh was extended to anterior and posterior vaginal wall for the repair of concurrent cystocele and rectocele, if indicated. The surgical results and complications were evaluated. The prolapse evaluation was performed according to International Continence Society (ICS) ordinal stages of pelvic organ prolapse. RESULTS: The mean age was 55 years. The mean follow-up was 2.9 years (range 1.0-5.5 years). Repeated sacrospinous ligament fixation was performed for all patients. Eleven were performed unilaterally to the right and four to the left. The average time for sacrospinous fixation was 20 min. The average blood loss for sacrospinous fixation was 75 ml. No major complication except one accidental rectotomy was observed. It was repaired intraoperatively without sequel. The concurrent pelvic surgeries included vaginal total hysterectomies, anterior colporrhaphies, posterior colporrhaphies, and tension-free vaginal tape procedures. No recurrence of apical prolapse was observed. However, two patients developed stage I prolapse on anterior vaginal wall (cystocele) and required no further repair. Minor postoperative complications were observed. CONCLUSION: Repeated sacrospinous ligament fixation with mesh interposition and reinforcement is a safe and effective procedure for the correction of recurrent vault prolapse. The extended implanted mesh can be used for the repair of concurrent cystorectocele effectively. A long-term follow-up is necessary to detect any late complication. SN - 0001-6349 UR - https://www.unboundmedicine.com/medline/citation/16167917/Repair_of_recurrent_vaginal_vault_prolapse_using_sacrospinous_ligament_fixation_with_mesh_interposition_and_reinforcement_ L2 - https://doi.org/10.1111/j.0001-6349.2005.00821.x DB - PRIME DP - Unbound Medicine ER -