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

Year 2019, Volume: 44 Issue: 2, 549 - 555, 30.06.2019

Hanifi Şahin İbrahim Yalçın Eda Adeviye Şahin Mustafa Erkan Sarı Ali Ayhan

https://doi.org/10.17826/cumj.457925

Abstract

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 post-hysterectomy vaginal vault prolapse.

Keywords

Sacrospinous ligament, vaginal prolapse, hysterectomy

Evre 3-4 vajinal cuff prolapsusu tedavisinde konvansiyonel enstrümanlar kullanılarak sakrospinöz ligament fiksasyon sonuçları

Abstract

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. 

Keywords

Sacrospinous ligament, vaginal prolapse, hysterectomy

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