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Published in: Archives of Gynecology and Obstetrics 6/2013

01-06-2013 | General Gynecology

Risk factors of surgical failure following sacrospinous colpopexy for the treatment of uterovaginal prolapse

Authors: Ayman Qatawneh, Fida Thekrallah, Majed Bata, Fawaz Al-kazaleh, Mahmoud Almustafa, Ilham Abu-kader

Published in: Archives of Gynecology and Obstetrics | Issue 6/2013

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Abstract

Purpose

Trans-vaginal sacrospinous colpopexy is one of the surgical procedures used to repair varying degrees of vaginal vault and uterovaginal prolapse. The purpose of this study is to analyse the potential risk factors of surgical failure following sacrospinous colpopexy.

Methods

A retrospective study of 114 women who underwent unilateral sacrospinous colpopexy at Jordan University Hospital from January 2005 to January 2008 were included. Patient demographics, clinical characteristics and concomitant pelvic organ prolapse surgery were assessed. The patients were evaluated at 6 weeks, and every 6 months thereafter. Twelve (11 %) had recurrent apical (vaginal cuff) prolapse, 26 (23 %) had recurrent prolapse at any compartment were compared with those who had successful surgery. Univariate and logistic regression analyses were used to assess the independent prognostic values of the variables associated with surgical failure.

Results

After a mean follow-up of 40 months, the statistically significant predictors of surgical failure included the presence of advanced pre-operative stages of prolapse (stages III and IV), the more distally located points Ba, Bp and C and a lack of mesh augmentation of the anterior vaginal wall during surgery (P = 0.01, 0.027, 0.024, 0.034 and 0.006, respectively). However, a history of prior vaginal repair, the more distally located point Ba and a lack of anterior vaginal wall mesh augmentation were defined as independent predictive variables based on logistic regression analyses (P = 0.04, 0.005 and 0.046, respectively).

Conclusions

The presence of advanced anterior vaginal wall prolapse, prior vaginal repair and a lack of mesh augmentation of the anterior compartment are significant risk factors for the surgical failure of sacrospinous suspension surgery.
Literature
1.
go back to reference Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF (1999) Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 180:299–305PubMedCrossRef Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF (1999) Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 180:299–305PubMedCrossRef
2.
go back to reference Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMedCrossRef Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMedCrossRef
3.
go back to reference Randall CL, Nichols DH (1971) Surgical treatment of vaginal eversion. Obstet Gynecol 38:327–332PubMed Randall CL, Nichols DH (1971) Surgical treatment of vaginal eversion. Obstet Gynecol 38:327–332PubMed
4.
go back to reference Sze EHM, Karram MM (1997) Transvaginal repair of vault prolapse: a review. Obstet Gynecol 89:466–475PubMedCrossRef Sze EHM, Karram MM (1997) Transvaginal repair of vault prolapse: a review. Obstet Gynecol 89:466–475PubMedCrossRef
5.
go back to reference Nichols DH (1982) Sacrospinous fixation for massive eversion of the vagina. Am J Obstet Gynecol 142:901–904PubMed Nichols DH (1982) Sacrospinous fixation for massive eversion of the vagina. Am J Obstet Gynecol 142:901–904PubMed
6.
go back to reference Morley GW, De Lancey JO (1988) Sacrospinous ligament fixation for eversion of the vagina. Am J Obstet Gynecol 158:872–879PubMed Morley GW, De Lancey JO (1988) Sacrospinous ligament fixation for eversion of the vagina. Am J Obstet Gynecol 158:872–879PubMed
7.
go back to reference Richter K, Albrich W (1981) Long term results following fixation of the vagina on the sacrospinal ligament by the vaginal route (vaginaefixatio sacrospinalis vaginalis). Am J Obstet Gynecol 141:811–816PubMed Richter K, Albrich W (1981) Long term results following fixation of the vagina on the sacrospinal ligament by the vaginal route (vaginaefixatio sacrospinalis vaginalis). Am J Obstet Gynecol 141:811–816PubMed
8.
go back to reference Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef
9.
go back to reference de Tayrac R, Gervaise A, Chauveaud A, Fernandez H (2005) Tension-free polypropylene mesh for vaginal repair of anterior vaginal wall prolapse. J Reprod Med 50(2):75–80PubMed de Tayrac R, Gervaise A, Chauveaud A, Fernandez H (2005) Tension-free polypropylene mesh for vaginal repair of anterior vaginal wall prolapse. J Reprod Med 50(2):75–80PubMed
10.
go back to reference Miyazaki FS (1987) Miya Hook ligature carrier for sacrospinous ligament suspension. Obstet Gynecol 70:286–288PubMed Miyazaki FS (1987) Miya Hook ligature carrier for sacrospinous ligament suspension. Obstet Gynecol 70:286–288PubMed
11.
go back to reference Maher CF, Qatawneh AM, Baessler K, Schluter PJ (2004) Midline rectovaginal fascial plication for repair of rectocele and obstructed defecation. Obstet Gynecol 104:685–689PubMedCrossRef Maher CF, Qatawneh AM, Baessler K, Schluter PJ (2004) Midline rectovaginal fascial plication for repair of rectocele and obstructed defecation. Obstet Gynecol 104:685–689PubMedCrossRef
12.
go back to reference Paraiso MF, Ballard LA, Walters MD, Lee JC, Mitchinson AR (1996) Pelvic support defects defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol 175:1423–1430PubMedCrossRef Paraiso MF, Ballard LA, Walters MD, Lee JC, Mitchinson AR (1996) Pelvic support defects defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol 175:1423–1430PubMedCrossRef
13.
go back to reference Maher CF, Murray CJ, Carey MP, Dwyer PL, Ugoni AM (2001) Iliococcygeus or sacrospinous fixation for vaginal vault prolapse. Am J Obstet Gynecol 98:40–44CrossRef Maher CF, Murray CJ, Carey MP, Dwyer PL, Ugoni AM (2001) Iliococcygeus or sacrospinous fixation for vaginal vault prolapse. Am J Obstet Gynecol 98:40–44CrossRef
14.
go back to reference Hoffman MS, Harris MS, Bouis PJ (1996) Sacrospinous colpopexy in the management of uterovaginal prolapse. J Reprod Med 41:299–303PubMed Hoffman MS, Harris MS, Bouis PJ (1996) Sacrospinous colpopexy in the management of uterovaginal prolapse. J Reprod Med 41:299–303PubMed
15.
go back to reference Holley RL, Varner RE, Gleason BP, Apffel LA, Scott S (1995) Recurrent pelvic support defects after sacrospinous ligament fixation for vaginal vault prolapse. J Am Coll Surg 180:444–448PubMed Holley RL, Varner RE, Gleason BP, Apffel LA, Scott S (1995) Recurrent pelvic support defects after sacrospinous ligament fixation for vaginal vault prolapse. J Am Coll Surg 180:444–448PubMed
16.
go back to reference Heinonen PK (1992) Transvaginal sacrospinous colpopexy for vaginal vault and complete genital prolapse in aged women. Acta Obstet Gynecol Scand 71:377–381PubMedCrossRef Heinonen PK (1992) Transvaginal sacrospinous colpopexy for vaginal vault and complete genital prolapse in aged women. Acta Obstet Gynecol Scand 71:377–381PubMedCrossRef
17.
go back to reference Nieminen K, Huhtala H, Heinonen P (2003) Anatomic and functional assessment and risk factors of recurrent prolapse after vaginal sacrospinous fixation. Acta Obstet Gynecol Scand 82:471–478PubMedCrossRef Nieminen K, Huhtala H, Heinonen P (2003) Anatomic and functional assessment and risk factors of recurrent prolapse after vaginal sacrospinous fixation. Acta Obstet Gynecol Scand 82:471–478PubMedCrossRef
18.
go back to reference Whiteside J, Weber A, Meyn LA, Walters MD (2004) Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 191:1533–1538PubMedCrossRef Whiteside J, Weber A, Meyn LA, Walters MD (2004) Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 191:1533–1538PubMedCrossRef
19.
go back to reference Diez-Itza I, Azipitarte I, Beccerro A (2007) Risk factors for the recurrence of pelvic organ prolapse after vaginal surgery: a review at 5 years after surgery. Int Urogynecol J Pelvic Floor Dysfunct 18:1317–1324PubMedCrossRef Diez-Itza I, Azipitarte I, Beccerro A (2007) Risk factors for the recurrence of pelvic organ prolapse after vaginal surgery: a review at 5 years after surgery. Int Urogynecol J Pelvic Floor Dysfunct 18:1317–1324PubMedCrossRef
20.
go back to reference Lin TY, Su TH, Wang YL, Lee MY, Hsieh CH, Wang KG, Chen GD (2005) Risk factors for failure of transvaginal sacrospinous uterine suspension in the treatment of uterovaginal prolapse. J Formos Med Assoc 104(4):249–253PubMed Lin TY, Su TH, Wang YL, Lee MY, Hsieh CH, Wang KG, Chen GD (2005) Risk factors for failure of transvaginal sacrospinous uterine suspension in the treatment of uterovaginal prolapse. J Formos Med Assoc 104(4):249–253PubMed
21.
go back to reference Chen H-Y, Chiu T-H, Ho M, Hung Y-C (2009) Analysis of risk factors associated with surgical failure of sacrospinous suspension for uterine or vaginal vault prolapse. Int Urogynecol J Pelvic Floor Dysfunct 20:387–391PubMedCrossRef Chen H-Y, Chiu T-H, Ho M, Hung Y-C (2009) Analysis of risk factors associated with surgical failure of sacrospinous suspension for uterine or vaginal vault prolapse. Int Urogynecol J Pelvic Floor Dysfunct 20:387–391PubMedCrossRef
22.
go back to reference Benson JT, Lucente V, McClellan E (1996) Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1421PubMedCrossRef Benson JT, Lucente V, McClellan E (1996) Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1421PubMedCrossRef
23.
go back to reference Maher CF, Qatawneh A, Dwyer PL, Carey MP, Cornish A, Schluter P (2004) Abdominal sacral colpopexy for vaginal vault prolapse. A prospective randomized trial. Am J Obstet Gynecol 190:20–26PubMedCrossRef Maher CF, Qatawneh A, Dwyer PL, Carey MP, Cornish A, Schluter P (2004) Abdominal sacral colpopexy for vaginal vault prolapse. A prospective randomized trial. Am J Obstet Gynecol 190:20–26PubMedCrossRef
24.
go back to reference Maher C, Baessler K, Glazener MC, Adams EJ, Hagen S (2007) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 18:CD004014 Maher C, Baessler K, Glazener MC, Adams EJ, Hagen S (2007) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 18:CD004014
25.
go back to reference Tsia-Shu L, Kiran A (2011) Combined anterior trans-obturator mesh and sacrospinous ligament fixation in women with severe prolapse—a case series of 30 months follow-up. Int Urogynecol J Pelvic Floor Dysfunct 22:299–306 Tsia-Shu L, Kiran A (2011) Combined anterior trans-obturator mesh and sacrospinous ligament fixation in women with severe prolapse—a case series of 30 months follow-up. Int Urogynecol J Pelvic Floor Dysfunct 22:299–306
26.
go back to reference Clark A, Gregory T, Smith V, Edwards R (2003) Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 189:1261–1267PubMedCrossRef Clark A, Gregory T, Smith V, Edwards R (2003) Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 189:1261–1267PubMedCrossRef
Metadata
Title
Risk factors of surgical failure following sacrospinous colpopexy for the treatment of uterovaginal prolapse
Authors
Ayman Qatawneh
Fida Thekrallah
Majed Bata
Fawaz Al-kazaleh
Mahmoud Almustafa
Ilham Abu-kader
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 6/2013
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-012-2685-8

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