Transvaginal Sacrospinous Ligament Fixation: Revisited in Modern Gynecology
Shraddha S Shastri, Sameer P Darawade, Nikita R Yedage
Citation Information :
Shastri SS, Darawade SP, Yedage NR. Transvaginal Sacrospinous Ligament Fixation: Revisited in Modern Gynecology. J South Asian Feder Obs Gynae 2020; 12 (3):155-158.
Background: To evaluate intraoperative and postoperative complications and to evaluate recurrence of vault prolapse in women who have undergone unilateral (left) sacrospinous ligament fixation. Aim: To evaluate safety, effectiveness, and ease of sacrospinous ligament fixation for prevention and treatment of vaginal vault prolapse. Materials and methods: This study was conducted between January 2016 and October 2017 at Smt. Kashibai Navale Medical College and General Hospital, Pune. This study included 106 patients (out of which18 had vault prolapse and 88 patients had III or IV degree uterine prolapse). Concomitant hysterectomy and sacrospinous ligament fixation were done in 88 patients with uterine prolapse, and patients with vault prolapse underwent sacrospinous ligament fixation. Sacropinous ligament fixation was combined with any other additional procedure if required for that patient. Results: All complications including intraoperative and postoperative were noted in all patients. One patient had rectal injury (n = 1; 0.94%), 1 patient had abscess (n = 1; 0.94%), 1 patient had hemorrhage requiring blood transfusion (n = 1;0.94%), 1 patient had cystocele (n = 1; 0.94%), 3 patients had urinary tract infection (n = 3; 2.8%), 16 patients had postoperative fever (n = 16; 15%), 21 patients had postoperative pain (n = 21; 20%), and 2 patients had sciatic neuralgia (n = 2; 2.8%). No recurrence of vault prolapse was noted. Conclusion: Sacrospinous ligament fixation is a safe, effective, and simple procedure for prevention and treatment of vaginal vault prolapse.
Pelvic organ support study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol 2005;192(3):795–806. DOI: 10.1016/j.ajog.2004.10.602.
Pelvic floor disorders network. Prevalence of symptomatic pelvic floor disorders in US women. JAMA 2008;300(11):1311–1316. DOI: 10.1001/jama.300.11.1311.
Epidemiology of surgically managed pelvic organ prolapsed and urinary incontinence. Obstet Gynecol 1997;89(4):501–506. DOI: 10.1016/S0029-7844(97)00058-6.
Reoperation rate 10 years after surgically managed pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 2008;198(5):555.e1–555.e5. DOI: 10.1016/j.ajog.2008.06.049.
Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review. Systematic review group of the society of gynecologic surgeons. Int Urogynecol J 2011;22(7):789–798. DOI: 10.1007/s00192-011-1384-5.
Graft use in transvaginal pelvic organ prolapse repair: a systematic review. Society of gynecologic surgeons systematic review group. Obstet Gynecol 2008;112(5):1131–1142. DOI: 10.1097/AOG.0b013e3181898ba9.
Anatomy of the female pelvis. In: Thompson JD, Rock JA, ed. Te Linde's operative gynecology. 7th ed., Philadelphia: Lippincott; 1992. pp. 33–65.
Vaginographic examination of the pelvic floor. Inturogynec J 1994;5:19–24. DOI: 10.1007/BF00451707.
Sacrospinous ligament fixation for eversion of the vagina. Am J Obstet Gynecol 1988;158(4):872–881. DOI: 10.1016/0002-9378(88)90088-9Pubmed pmid: 3364499.
Sacrospinous ligament fixation for vaginal vault prolapse: complications and results. J Gynec Surg 1991;7(2):87–92. DOI: 10.1089/gyn.1991.7.87.
Surgery in prolapse of a blind-end vagina. Geburtshilfe Frauenheilkd 1958;18(6):824–828.
The surgical treatment of the prolapsed vaginal fundus after uterine extirpation. A contribution on Amreich's the sacrotuberal vaginal fixation. Geburtshilfe Frauenheilkd 1967;27(10):941–954.
Surgical treatment of vaginal inversion. Obstet Gynecol 1971;38(3):327–332.
Surgical techniques for vault prolapse: a review of the literature. Eur J Obstet Gynecol Reprod Biol 2005;119(2):144–155. DOI: 10.1016/j.ejogrb.2004.06.042PubMed PMID: 15808370.
Transvaginal sacrospinous ligament fixation for pelvic organ prolapse stage III and stage IV uterovaginal and vault prolapse. Iran J Med Sci 2015;40(1):58–62.
Sacrospinous suspension: a local practitioner's experience. Am J Obstet Gynecol 1995;173(2):440–445. DOI: 10.1016/0002-9378(95)90264-3PubMed PMID: 7645619.
