Sacrospinous Ligament Fixation – A Malaysian’s Tertiary Centre Experience
- Author:
Ab Latip N
;
Ng PY
- Publication Type:Journal Article
- Keywords:
Gynaecological surgery;
pelvic organ prolapse;
urogenital prolapse;
vaginal hysterectomy;
vagina lvault prolapse
- MeSH:
Hysterectomy, Vaginal
- From:Journal of Surgical Academia
2017;7(1):21-
- CountryMalaysia
- Language:English
-
Abstract:
During the study period from January 2008 to December 2012, 177 women had transvaginal sacrospinous ligament
fixation (SSF) for vault suspension at General Hospital Kuala Lumpur. Of the 177 women, 133 (75.1%) had severe
uterovaginal prolapse while 44 (24.9%) had post-hysterectomy vault prolapse. All patients with severe uterovaginal
prolapse and rectocele undergone vaginal hysterectomy and posterior colporrhaphy respectively. A hundred and
seventy-four patients (98.3%) had anterior repair whilst 48 (27.1%) received midurethral sling as concomitant
procedure to vault suspension (SSF). The mean duration of surgery was 92.1±30.2 minutes and the mean estimated
blood loss was 319±199.3mls. There was no surgical mortality. Two patients (1.1%) had rectal injuries. No patient
had bladder injury or de novo urinary symptoms. The commonest immediate postoperative complications was fever
(98; 55.4%) followed by buttock pain in 18 (10.2%) patients. Both complications were resolved with conservative
measures. Seven patients (3.9%) had sutures erosion as late complications. Of the 177 women, 158 (89.3%) and 141
(79.7%) came for the 6 and 12 months follow-up, respectively. The success rate for all three compartments ranged
from 92.4% to 98.1% at 6 months and reduced to range from 85.7% to 94.4% at 12 months. The highest success rate
was observed in the posterior compartment followed by apical and anterior compartment. Equally, the recurrence
rate was lowest in the posterior compartment (1.9%), followed by the central (3.8%) and anterior compartment
(7.5%) at 6 months’ review. This increased to 5.7% for rectocele, 7.8% for vault prolapse and 14.2% for cystocele at
12 months’ follow-up. None had repeated surgery for prolapse recurrence during the study period. In conclusion,
SSF remains a high priority in our therapeutic regime for the treatment of severe uterovaginal and vault prolapse as it
has a reasonably good success rate with lower serious complications in the skillful hands.
- Full text:P020170530329394499935.pdf
