Sacrospinous Ligament Fixation Under Local Anesthesia in Elderly Patients at High Risk of General Anesthesia

Şentürk, Mehmet Baki; Doğan, Ozan

doi:10.1080/08941939.2018.1466218

Cited by 14 publications

(17 citation statements)

References 27 publications

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“…We attribute this to the anchoring system requiring less dissection and consequently reducing the amount of bleeding [27]. In the literature, sacrospinous fixation with Anchorsure under local anesthesia has also been described in older patients and patients with anesthesia risks [28].…”

Section: Clinical Outcomes and Complicationsmentioning

confidence: 99%

Comparison of Unilateral and Bilateral Sacrospinous Ligament Fixation Using Minimally Invasive Anchorage

Salman

Babaoğlu

Kumbasar

et al. 2019

Geburtshilfe Frauenheilkd

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Objective The aim of this study was to determine the effectiveness of a newly developed anchoring system for unilateral sacrospinous ligament fixation (USSLF) and bilateral sacrospinous ligament fixation (BSSLF) procedures. Material and Methods Ninety-three patients with pelvic prolapse who were treated surgically with the Anchorsure System® between 2013 and 2018 were included in the study. USSLF was performed in 52 patients (group 1), and BSSLF was performed in 41 patients (group 2). Pelvic organ prolapse was assessed preoperatively and 6 months postoperatively. Results There were no significant differences between groups 1 and 2 with regard to age, parity, and demographic characteristics. Anatomical improvement rates were similar, irrespective of the type of SSLF used. No bleeding requiring blood transfusion or organ injuries occurred in any patient. Three patients in the group that received BSSLF developed small asymptomatic cystoceles (grade 1 to 2); there was no recurrence of rectoceles or enteroceles. Mild cystocele was found in 1 patient from the USSLF group. There was no significant difference between the groups with respect to the recurrence of cystocele. Recurrence of vaginal vault prolapse was found in 2 patients from the USSLF group (3.84%). There was no significant difference between the groups with regard to recurrence. Febrile morbidity, clinical outcomes, blood loss, duration of operation, intraoperative complications, and length of hospital stay were similar for the two groups. Conclusions Unilateral and bilateral SSLF techniques produce similar clinical outcomes. USSLF and BSSLF performed using the new anchoring system are safe and effective methods to treat pelvic organ prolapse.

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Section: Clinical Outcomes and Complicationsmentioning

confidence: 99%

Comparison of Unilateral and Bilateral Sacrospinous Ligament Fixation Using Minimally Invasive Anchorage

Salman

Babaoğlu

Kumbasar

et al. 2019

Geburtshilfe Frauenheilkd

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“…For patients who underwent surgery for SUI, Schatz et al recorded a subjective pain estimation of 5 mm on the 100 mm Visual Analogue scale foratotal of 110 patients, while the respective mean score by Gagnon et al was 19 mm immediately after surgery 19,24 . Similarly, for patients who underwent POP surgery, in the study by Senturk et al, sacrospinous ligament fixation was not associated with intraoperative pain presenting a mean value of 2.18 mm (100 mm VAS) 28 . Additionally, Flam et al, assessed intraoperative pain in patients who underwent POP repair with mesh using a 10 cm VAS.…”

Section: Resultsmentioning

confidence: 99%

“…Perioperative pain measured by Visual Analogue Scale (VAS) was assessed in 5 of the noncomparative studies. 19,23,24,28,29 For patients who underwent surgery for SUI, Schatz et al recorded a subjective pain estimation of 5 mm on the 100 mm Visual Analogue scale foratotal of 110 patients, while the respective mean score by Gagnon et al was 19 mm immediately after surgery. 19,24 Similarly, for patients who underwent POP surgery, in the study by Senturk et al, sacrospinous ligament fixation was not associated with intraoperative pain presenting a mean value of 2.18 mm (100 mm VAS).…”

Section: Perioperative Pain Scores and Patients' Satisfactionmentioning

confidence: 99%

Pelvic floor reconstructive surgery under local anesthesia: A systematic review and meta‐analysis

Zacharakis

Prodromidou

Douligeris

et al. 2021

Neurourology and Urodynamics

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Aims: The decision on the appropriate type of anesthesia for pelvic floor repair depends on a variety of factors including patients' age, performance status, comorbidities, cost-effectiveness and personal preferences. We aim to review the literature on urogynecological procedures performed under local anesthesia (LA).Methods: A systematic search of four electronic databases was conducted for articles published up to May 2020. Studies reporting outcomes of women who underwent pelvic floor reconstructive surgery under LA with or without sedation, were considered eligible.Results: Nineteen studies (14 noncomparative and 5 comparative), including 1626 cases of urogynecological procedures under LA were recruited. Metaanalysis revealed significantly lower mean pain scores in LA group compared to general-regional anesthesia one (GA/RA) at both 4-6 h and 8-18 h postoperatively (160 patients; mean difference [MD], −1.70; 95% confidence interval [CI]: −3.12, −0.28; p = 0.02 and 160 patients; MD, −0.72; 95% CI: −1.17, 0.27; p = 0.002, respectively). Pain scores at >24 h did not differ among the two groups (160 patients; MD, −0.28; 95% CI: −0.60-0.05; p = 0.10). Intra-and postoperatively morphine use was not different among patients who received LA and GA during prolapse surgery while nausea rates were significantly lower in LA group compared to RA group 8 h postoperatively. Conclusions: LA with or without sedation represents a safe and efficient alternative anesthetic technique for urogynecological procedures with improved pain scores in up to 18 h postoperatively especially in patients who underwent surgery for SUI. LA is feasible and could be offered to patients undergoing pelvic floor surgery allowing a prompt postoperative recovery.

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“…Sentürk et al 16 reported that SSLF was successful with local anesthesia in 11 elderly patients who had a high risk for general anesthesia. The authors observed no complication, despite the use of local anesthesia, and only two patients had relapse after two years.…”

Section: Discussionmentioning

confidence: 99%

Outcome of sacrospinous ligament fixation with conventional instruments in the treatment of Stage 3-4 vaginal vault prolapse

Şahin

Yalçın

Şahin

et al. 2019

Cukurova Medical Journal

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Öz Purpose: The objective of this study was to investigate the effectiveness of the sacrospinous ligament fixation (SSLF) at 12 months following the operation. Materials and Methods: This retrospective study included patients diagnosed with vaginal vault prolapse and underwent SSLF between January 2014 and May 2017. The subjective evaluation was performed according to the Patient Global Impression of Improvement (PGI-I). The objective success rate at the end of 12 months was evaluated, and the Pelvic Organ Prolapse-Quantification System (POP-Q) Stage 0 or 1 was considered as a successful outcome. The effectiveness of the operation and the complication rates were evaluated during one-year follow-up. Results: A total of 26 patients were included in the study. Twelve patients (46.2%) underwent unilateral SSLF and 14 patients (53.8%) bilateral SSLF operation. At 12 months, the objective and subjective success rates were 100% and 100%, respectively. There was a significant difference between the unilateral and bilateral SSLF groups in terms of the operation time and intraoperative bleeding. After one-year follow-up, only three patients (11.3%) complained about mild gluteal pain. Conclusion: The suspension of the vagina to the unilateral or bilateral sacrospinous ligament was an effective and safe surgical method in patients with posthysterectomy vaginal vault prolapse. Amaç: Çalışmamızda sakrospinöz ligament fiksasyonunun (SSLF) ameliyat sonrası 12 aylık dönemdeki etkinliği araştırıldı. Gereç ve Yöntem: Çalışmaya Ocak 2014 ve Mayıs 2017 tarihleri arasında vajinal cuff prolapsusu tanısı almış ve SSLF uygulanmış hastalar dahil edildi. Sübjektif değerlendirme Hasta Global Düzelme İzlenimi (PGI-I) skorlama sistemi kullanılarak gerçekleştirildi. 12. ayda objektif başarı oranı değerlendirildi ve Pelvik Organ Prolapsusu-Kantifikasyon Sistemi (POP-Q) Evre 0 veya 1 sonuçları objektif başarı kriteri olarak kabul edildi. Operasyonun bir yıllık dönemdeki etkinliği ve komplikasyon oranları değerlendirildi. Bulgular: Toplam 26 hasta çalışmaya dahil edildi. On iki hastaya (%46.2) unilateral SSLF uygulanırken, 14 hastaya (%53.8) bilateral SSLF yapıldı. Objektif ve sübjektif başarı oranı 12. ayda sırasıyla %100 ve %100 idi. Bilateral ve unilateral SSLF uygulanmış gruplar arasında ameliyat süresi ve intraoperatif kanama miktarı yönünden anlamlı bir fark izlendi. Bir yıllık takibin sonunda yalnızca üç hastada hafif şiddette gluteal ağrı gözlendi. Sonuç: Unilateral veya bilateral sakrospinöz ligament süspansiyonunun histerektomi sonrası vajinal cuff prolapsusu olan kadınlarda etkili ve güvenli bir cerrahi yöntem olduğunu göstermektedir.

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Sacrospinous Ligament Fixation Under Local Anesthesia in Elderly Patients at High Risk of General Anesthesia

Abstract: The results of this study demonstrated the surgical and anesthetic safety of SSLF under local anesthesia for pelvic organ prolapse in elderly patients.

Cited by 14 publications

References 27 publications

Comparison of Unilateral and Bilateral Sacrospinous Ligament Fixation Using Minimally Invasive Anchorage

Comparison of Unilateral and Bilateral Sacrospinous Ligament Fixation Using Minimally Invasive Anchorage

Pelvic floor reconstructive surgery under local anesthesia: A systematic review and meta‐analysis

Outcome of sacrospinous ligament fixation with conventional instruments in the treatment of Stage 3-4 vaginal vault prolapse

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