Uncommon complications of sacrospinous fixation for treatment of vaginal vault prolapse

Silva-Filho, Agnaldo L.; Santos-Filho, Admário S.; Figueiredo-Netto, Octacílio; Triginelli, Sérgio A.

doi:10.1007/s00404-004-0710-2

Cited by 12 publications

(2 citation statements)

References 20 publications

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“…8 Most of these hernias appear within 1 year following the surgery, 1 which is what occurred in the present case (at * 6 months). The anterior types of perineal hernias, categorized based on their position relative to the transverse perineal muscle, occur exclusively in females.…”

Section: Discussionmentioning

confidence: 59%

Recurrent Perineal Hernia After Benign Pelvic Reconstructive Surgery

Rodriguez

Casey

Bazan

et al. 2012

Journal of Gynecologic Surgery

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Background: Secondary acquired perineal hernias are rare events usually associated with extensive pelvic surgery. Although most are asymptomatic, when symptoms are present surgical intervention is warranted. There is currently no consensus regarding the management of these hernias. An unusual case of a recurrent perineal hernia following sacrospinous fixation resulting in large bowel incarceration is reported. Case: A 64-year-old woman presented with an anterior vaginal wall prolapse and multiple pelvic-floor defects. She subsequently underwent a sacrospinous fixation and enterocele repair. The enterocele recurred and she underwent a second enterocele repair. Approximately 6 months later, she presented with a perineal hernia that involved an incarceration of the large bowel. Results: The hernia was reduced, the pelvic-floor defect was repaired, and a biologic, absorbable mesh was applied. Approximately 5 months later, the patient presented with a recurrence of the perineal hernia. The hernia was reduced and this time a synthetic, nonabsorbable mesh was used, and there were no signs of recurrence at 6 months' follow-up. Conclusions: Acquired perineal hernias are extremely rare events, especially when they recur and involve large bowel incarceration. Several factors may influence the development and possible recurrence of secondary acquired perineal hernias, including lifestyle, occupation, gestational history, and past medical and surgical history. The use of a nonabsorbable mesh to prevent recurrence is suggested, although current literature reports success rates that are fairly similar for users of both absorbable and nonabsorbable meshes. ( J GYNECOL SURG 28:230)

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Section: Discussionmentioning

confidence: 59%

Recurrent Perineal Hernia After Benign Pelvic Reconstructive Surgery

Rodriguez

Casey

Bazan

et al. 2012

Journal of Gynecologic Surgery

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“…There are also a few case reports on debilitating complications following SSLF such as perineal necrotising infection, perineal herniae, left lateral enterocoele after right SSLF (Silva-Filho et al 2005), ischiorectal abscess (Hibner et al 2005) and myositis of the gluteal region (Faber et al 2008). Pohl and Frattarelli (1997) concluded that the bilateral suspension is different from the unilateral suspension in that the former requires significant intraoperative judgement in its feasibility and in maintaining the width of the vaginal cuff to allow a bilateral suspension without tension.…”

Section: Results and Complicationsmentioning

confidence: 96%

The sacrospinous ligament: Conveniently effective or effectively convenient?

Rane¹,

Frazer²,

Jain³

et al. 2011

Journal of Obstetrics and Gynaecology

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The sacrospinous ligament has been used for over 50 years as a convenient structure for treating vaginal vault and more recently, uterine prolapse. The procedure has evolved over the years and its efficacy has been hotly debated with invariable comparisons made to abdominal sacral colpopexy. Mesh surgery has introduced a newer dimension to the debate. This review is an attempt to clarify the anatomy, reflect on various techniques and offer a critique on the current 'status' of the sacrospinous ligament.

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