Long-term results following fixation of the vagina on the sacrospinal ligament by the vaginal route (vaginaefixatio sacrospinalis vaginalis)

Richter, K; Albrich, Werner C.

doi:10.1016/0002-9378(81)90709-2

Cited by 146 publications

(74 citation statements)

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“…Our findings agree with those of Richter and Albrich [16], who suggested that sacrospinous fixation does not predispose to dyspareunia unless vaginal narrowing occurs due to repair of associated defects and reported a 10% apareunia rate for 36 patients. Fortunately, we found no case of apareunia or any substantial narrowing in our series.…”

Section: Discussionsupporting

confidence: 92%

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Sexual function after sacrospinous fixation for vaginal vault prolapse: bad or mad?

et al. 2008

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Background The main indication for sacrospinous ligament suspension is to correct either total procidentia, a posthysterectomy vaginal vault prolapse with an associated weak cardinal uterosacral ligament complex, or a posthysterectomy enterocele. This study aimed to evaluate sexual function and anatomic outcome for patients after sacrospinous ligament suspension. Methods For this study, 52 patients who had undergone sacrospinous ligament fixation during the preceding 5 years were asked to complete the Female Sexual Function Index (FSFI) questionnaire. The patients were vaginally examined using the ICS POP score, and the results were compared with their preoperative status. For statistical analysis, GraphPad for Windows, version 4.0, was used. Results The 52 patients were examined during a followup period of 38 months. No major intraoperative complications were noted. Recurrence of symptomatic apical descent was noted in 6% of the patients and de novo prolapse in 13.5%. Only one patient was symptomatic. Three patients experienced de novo dyspareunia, which resolved in two cases after stitch removal. Sexual function was good, rating higher than three points for each of the domains including satisfaction, lubrication, desire, orgasm, and pain. Conclusion Sacrospinous ligament fixation still is a valuable option for the treatment of vaginal vault prolapse.Sexual function is satisfactory, with few cases of de novo dyspareunia.

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Section: Discussionsupporting

confidence: 92%

“…Because of the distorted vaginal axis, dyspareunia is a postoperative complication with an incidence ranging from 0% to 16% [16,17]. Additional potential complications include voiding dysfunction, postoperative urinary incontinence, and evisceration [18].…”

Section: Introductionmentioning

confidence: 99%

Sexual function after sacrospinous fixation for vaginal vault prolapse: bad or mad?

et al. 2008

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“…6 Richter popularised the sacrospinous ligament fixation procedure. 7 The abdominal procedure includes sacral colpopexy. A clear and thorough understanding of the supporting mechanisms for the uterus and the vagina is important in order to make the right choice of the corrective procedure and also to minimise the risk of post hysterectomy occurrence of vault prolapse.…”

Section: Introductionmentioning

confidence: 99%

Sacrospinous ligament fixation for prevention and treatment of vaginal vault prolapse: a retrospective study of 45 cases

Kamat

Shilpa

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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“…Vaginal sacrospinous colpopexy is the most commonly performed transvaginal suspension procedure for vaginal vault prolapse repair [17] . The described advantages include avoiding the morbidity of an abdominal incision and the ability to repair concomitant anterior and posterior compartment defects using the same surgical site.…”

Section: Discussionmentioning

confidence: 99%

Sacral Colpopexy with Concurrent Burch Colposuspension in Patients with Vaginal Vault Prolapse

Wille¹,

Braun²,

Heidenreich

et al. 2006

Urol Int

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Introduction: Abdominal sacral colpopexy (SC) is one option in the management of vaginal vault prolapse. In patients who are additionally incontinent an anti-incontinence procedure such as a Burch colposuspension or pubovaginal sling is usually performed at the same time. For those patients undergoing SC who are continent there are no clear guidelines for the use of a ‘prophylactic’ anti-incontinence procedure. We describe our experience with SC and concurrent Burch colposuspension. Patients and Methods: 47 patients (mean age 65 years) underwent SC and concurrent Burch colposuspension. The preoperative diagnostic check-up included a validated questionnaire, clinical examination, urodynamic tests, ultrasound and colpocystorectography. Patients were also evaluated using Stress, Emptying, Anatomic, Protection and Instability (SEAPI) scores. All patients had a uterine or vaginal vault prolapse in combination with a cystocele, enterocele or rectocele. Thirty-three of 47 (70%) patients were continent and 14 (30%) incontinent. Nineteen (40%) of the 33 ‘continent’ patients were found to have occult incontinence. Clinical examination according to the Halfway system showed 9 of 47 (19%), 21 of 47 (45%) and 17 of 47 (36%) patients with grade 2, 3 and 4 vaginal vault prolapse, respectively. Thirty-five of 47 (74%) patients demonstrated a grade-4 cystocele and 12 of 47 (26%) a grade-3 cystocele. The mean follow-up was 34 months and included a questionnaire (SEAPI), clinical examination and ultrasound. Results: Postoperative SEAPI scores showed a statistically significant improvement in all SEAPI domains (p < 0.001). Ninety-four percent of the patients were satisfied, continent and would undergo the surgery again. Three patients were incontinent. No continent patient who underwent concurrent Burch colposuspension had obstructive symptoms or residual urine. Five patients (11%) who had dyspareunia preoperatively were free of this symptom postoperatively. Complications were: dilatation of the upper urinary tract in 2 patients (4%) secondary to distal ureteric deviation by suturing the posterior peritoneum. One patient underwent psoas hitch neoureterocystostomy and 1 patient was successfully treated by insertion of a ureteric stent for 6 weeks. One patient (2%) had a mesh infection necessitating removal of the Gore-Tex mesh. Conclusions: Sacral colpopexy provides good patient satisfaction, durable pelvic support and restores vaginal function. Due to excellent continence rates concurrent Burch colposuspension should be considered as a joint procedure even in continent patients.

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Long-term results following fixation of the vagina on the sacrospinal ligament by the vaginal route (vaginaefixatio sacrospinalis vaginalis)

Cited by 146 publications

References 0 publications

Sexual function after sacrospinous fixation for vaginal vault prolapse: bad or mad?

Sexual function after sacrospinous fixation for vaginal vault prolapse: bad or mad?

Sacrospinous ligament fixation for prevention and treatment of vaginal vault prolapse: a retrospective study of 45 cases

Sacral Colpopexy with Concurrent Burch Colposuspension in Patients with Vaginal Vault Prolapse

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