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Published in: International Urogynecology Journal 1/2011

01-01-2011 | Original Article

Laparoscopic sacrospinous ligament fixation for uterovaginal prolapse: experience with 93 cases

Authors: Yanzhou Wang, Dan Wang, Yuyan Li, Zhiqing Liang, Huicheng Xu

Published in: International Urogynecology Journal | Issue 1/2011

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Abstract

Introduction and hypothesis

The aim of this study was to investigate the technique, efficacy, and safety of laparoscopic sacrospinous ligament fixation (LSSLF) for patients with uterovaginal prolapse.

Methods

From May 2004 to December 2006, 93 patients underwent LSSLF at Southwest Hospital, Chongqing, China. All patients had either grade 3 or 4 uterovaginal prolapse. The surgical results and complications were evaluated.

Results

All patients had their surgery completed by LSSLF. The average time for LSSLF was 65 min. The average blood loss was 105 ml. Bladder was injured in four cases (4.3%). The mean follow-up was 18 months. Of the 93 patients, 87 (93.5%) had been cured of their vault or uterovaginal prolapse. Minor postoperative complications were observed.

Conclusions

LSSLF can be successfully completed in patients with uterovaginal prolapse. It is a safe and effective treatment method for patients with uterovaginal prolapse. A long-term follow-up is necessary to detect therapeutic effect and late complication.
Literature
1.
go back to reference Marchionni M, Bracco GL, Checcucci V, Carabaneanu A, Coccia EM, Mecacci F et al (1999) True incidence of vaginal vault prolapse. Thirteen years of experience. J Reprod Med 44(8):679–684PubMed Marchionni M, Bracco GL, Checcucci V, Carabaneanu A, Coccia EM, Mecacci F et al (1999) True incidence of vaginal vault prolapse. Thirteen years of experience. J Reprod Med 44(8):679–684PubMed
2.
go back to reference Dwyer PL, Lee ETC, Hay DM (1988) Obesity and urinary incontinence in women. Br J Obstet Gynaecol 95(1):91–96CrossRefPubMed Dwyer PL, Lee ETC, Hay DM (1988) Obesity and urinary incontinence in women. Br J Obstet Gynaecol 95(1):91–96CrossRefPubMed
3.
go back to reference Aigmueller T, Dungl A, Hinterholzer S, Geiss I, Riss P (2010) An estimation of the frequency of surgery for posthysterectomy vault prolapse. Int Urogynecol J 21:299–302CrossRef Aigmueller T, Dungl A, Hinterholzer S, Geiss I, Riss P (2010) An estimation of the frequency of surgery for posthysterectomy vault prolapse. Int Urogynecol J 21:299–302CrossRef
4.
go back to reference Dallenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson J-B, Boulvain M (2008) Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J 19:1623–1629CrossRef Dallenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson J-B, Boulvain M (2008) Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J 19:1623–1629CrossRef
5.
go back to reference Richter K (1982) Massive eversion of the vagina: pathogenesis, diagnosis, and therapy of the true prolapse of the vaginal stump. Clin Obstet Gynecol 25(4):897–912CrossRefPubMed Richter K (1982) Massive eversion of the vagina: pathogenesis, diagnosis, and therapy of the true prolapse of the vaginal stump. Clin Obstet Gynecol 25(4):897–912CrossRefPubMed
6.
go back to reference Cespedes RD (2000) Anterior approach bilateral sacrospinous ligament fixation for vaginal vault prolapse. Urology 56(6 Suppl 1):70–75CrossRefPubMed Cespedes RD (2000) Anterior approach bilateral sacrospinous ligament fixation for vaginal vault prolapse. Urology 56(6 Suppl 1):70–75CrossRefPubMed
7.
go back to reference Karram M, Goldwasser S, Kleeman S, Steele A, Vassallo B, Walsh P (2001) High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse. Am J Obstet Gynecol 185(6):1339–1342CrossRefPubMed Karram M, Goldwasser S, Kleeman S, Steele A, Vassallo B, Walsh P (2001) High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse. Am J Obstet Gynecol 185(6):1339–1342CrossRefPubMed
8.
go back to reference Podratz LK, Ferguson VR, Lee RA, Symmonds RE (1995) Abdominal sacralcolpopexy for posthysterectomy vaginal vault descensus. Obstet Gynecol 50:719–720 Podratz LK, Ferguson VR, Lee RA, Symmonds RE (1995) Abdominal sacralcolpopexy for posthysterectomy vaginal vault descensus. Obstet Gynecol 50:719–720
9.
go back to reference Natale F, Weir JM, Cervigni M (2006) Pelvic floor reconstructive surgery: which aspects remain controversial? Curr Opin Urol 16(6):407–412CrossRefPubMed Natale F, Weir JM, Cervigni M (2006) Pelvic floor reconstructive surgery: which aspects remain controversial? Curr Opin Urol 16(6):407–412CrossRefPubMed
10.
go back to reference Paraiso MF, Walters MD (2005) Laparoscopic surgery for stress urinary incontinence and pelvic organ prolapse. Clin Obstet Gynecol 48(3):724–736CrossRefPubMed Paraiso MF, Walters MD (2005) Laparoscopic surgery for stress urinary incontinence and pelvic organ prolapse. Clin Obstet Gynecol 48(3):724–736CrossRefPubMed
11.
go back to reference Beer M, Kuhn A (2005) Surgical techniques for vault prolapse: a review of the literature. Eur J Obstet Gynecol Reprod Biol 119(2):144–155CrossRefPubMed Beer M, Kuhn A (2005) Surgical techniques for vault prolapse: a review of the literature. Eur J Obstet Gynecol Reprod Biol 119(2):144–155CrossRefPubMed
12.
go back to reference Bump RC, Mattiasson A (1996) The standardization of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17CrossRefPubMed Bump RC, Mattiasson A (1996) The standardization of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17CrossRefPubMed
13.
go back to reference Ingelman-Sundberg A (1952) Urinary incontinence in women, excluding fistulas. Acta Obstet Gynecol Scand 31(3):266–291CrossRefPubMed Ingelman-Sundberg A (1952) Urinary incontinence in women, excluding fistulas. Acta Obstet Gynecol Scand 31(3):266–291CrossRefPubMed
14.
go back to reference Cosson M, Bogaert E, Narducci F, Querleu D, Crepin G (2000) Laparoscopic sacral colpopexy: short-term results and complications in 83 patients. J Gynecol Obstet Biol Reprod (Paris) 29(8):746–750 Cosson M, Bogaert E, Narducci F, Querleu D, Crepin G (2000) Laparoscopic sacral colpopexy: short-term results and complications in 83 patients. J Gynecol Obstet Biol Reprod (Paris) 29(8):746–750
15.
go back to reference Diwan A, Rardin CR, Strohsnitter WC, Weld A, Rosenblatt P, Kohli N (2006) Laparoscopic uterosacral ligament uterine suspension compared with vaginal hysterectomy with vaginal vault suspension for uterovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 17(1):79–83CrossRefPubMed Diwan A, Rardin CR, Strohsnitter WC, Weld A, Rosenblatt P, Kohli N (2006) Laparoscopic uterosacral ligament uterine suspension compared with vaginal hysterectomy with vaginal vault suspension for uterovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 17(1):79–83CrossRefPubMed
16.
go back to reference Richter K (1982) Massive eversion of the vagina: pathogenesis, diagnosis and therapy of the true prolapse of the vaginal stump. Clin Obstet Gynecol 25:897–912CrossRefPubMed Richter K (1982) Massive eversion of the vagina: pathogenesis, diagnosis and therapy of the true prolapse of the vaginal stump. Clin Obstet Gynecol 25:897–912CrossRefPubMed
17.
go back to reference Hewson AD (1998) Transvaginal sacrospinous colpopexy for posthysterectomy vault prolapse. Aust NZJ Obstet Gynaecol 38:318–324CrossRef Hewson AD (1998) Transvaginal sacrospinous colpopexy for posthysterectomy vault prolapse. Aust NZJ Obstet Gynaecol 38:318–324CrossRef
18.
go back to reference Cruikshank SH, Muniz M (2003) Outcomes study: a comparison of cure rates in 695 patients undergoing sacrospinous ligament fixation alone and with other site-specific procedures—a 16-year study. Am J Obstet Gynecol 188(6):1905–1515CrossRef Cruikshank SH, Muniz M (2003) Outcomes study: a comparison of cure rates in 695 patients undergoing sacrospinous ligament fixation alone and with other site-specific procedures—a 16-year study. Am J Obstet Gynecol 188(6):1905–1515CrossRef
19.
go back to reference Benson J, Lucente M, McClellan E (1996) Vaginal versus abdominal re-constructive surgery for the treatment of pelvic support defects: a prospective randomised study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1422CrossRefPubMed Benson J, Lucente M, McClellan E (1996) Vaginal versus abdominal re-constructive surgery for the treatment of pelvic support defects: a prospective randomised study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1422CrossRefPubMed
20.
go back to reference Pollak J, Takacs P, Medina C (2007) Complications of three sacrospinous ligament fixation techniques. Int J Gynaecol Obstet 99(1):18–22CrossRefPubMed Pollak J, Takacs P, Medina C (2007) Complications of three sacrospinous ligament fixation techniques. Int J Gynaecol Obstet 99(1):18–22CrossRefPubMed
21.
go back to reference Vancaillie T, Schuessler W (1991) Laparoscopic bladderneck suspension. J Laparoendosc Surg 1:169–173PubMed Vancaillie T, Schuessler W (1991) Laparoscopic bladderneck suspension. J Laparoendosc Surg 1:169–173PubMed
22.
go back to reference Pohl JF, Frattarelli JL (1997) Bilateral transvaginal sacrospinous colpopexy: preliminary experience. Am J Obstet Gynecol 177:1356–1362CrossRefPubMed Pohl JF, Frattarelli JL (1997) Bilateral transvaginal sacrospinous colpopexy: preliminary experience. Am J Obstet Gynecol 177:1356–1362CrossRefPubMed
23.
go back to reference Shull BL, Capen CV, Riggs MW, Kuehl TJ (1993) Bilateral attachment of the vaginal cuff to the iliococcygeus fascia: an effective method of cuff suspension. Am J Obstet Gynecol 168:1669–1677PubMed Shull BL, Capen CV, Riggs MW, Kuehl TJ (1993) Bilateral attachment of the vaginal cuff to the iliococcygeus fascia: an effective method of cuff suspension. Am J Obstet Gynecol 168:1669–1677PubMed
24.
go back to reference Nichols DH (1996) Transvaginal sacrospinous colpopexy. J Pelvic Surg 2:87–91 Nichols DH (1996) Transvaginal sacrospinous colpopexy. J Pelvic Surg 2:87–91
25.
go back to reference Elliott DS, Frank I, DiMarco DS, Chow GK (2004) Gynecologic use of robotically assisted laparoscopy: sacrocolpopexy for the treatment of high-grade vaginal vault prolapse. Am J Surg 188(S):52–56CrossRef Elliott DS, Frank I, DiMarco DS, Chow GK (2004) Gynecologic use of robotically assisted laparoscopy: sacrocolpopexy for the treatment of high-grade vaginal vault prolapse. Am J Surg 188(S):52–56CrossRef
26.
go back to reference Higgs P, Smith ARB (2003) Laparoscopy in urogynaecology. Rev Gynaecol Pract 3(3):132–136CrossRef Higgs P, Smith ARB (2003) Laparoscopy in urogynaecology. Rev Gynaecol Pract 3(3):132–136CrossRef
27.
go back to reference Ghoniem GM, Walters F, Lewis V (1994) The value of the vaginal pack test in large cystoceles. J Urol 152:931–934PubMed Ghoniem GM, Walters F, Lewis V (1994) The value of the vaginal pack test in large cystoceles. J Urol 152:931–934PubMed
28.
go back to reference Holley RL, Varner RE, Gleason BP, Apffel LA, Scott S (1996) Sexual function after sacrospinous ligament fixation for vaginal vault prolapse. J Reprod Med 41:355–358PubMed Holley RL, Varner RE, Gleason BP, Apffel LA, Scott S (1996) Sexual function after sacrospinous ligament fixation for vaginal vault prolapse. J Reprod Med 41:355–358PubMed
Metadata
Title
Laparoscopic sacrospinous ligament fixation for uterovaginal prolapse: experience with 93 cases
Authors
Yanzhou Wang
Dan Wang
Yuyan Li
Zhiqing Liang
Huicheng Xu
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 1/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1232-z

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