Management of recurrent vault prolapse
International Urogynecology Journal, 07/11/2011
Toh VV et al. – Current evidence suggests sacrospinous ligament fixation, and sacrocolpopexy are alternative surgical options to colpocleisis in treating recurrent vault prolapse. Randomised trials are required to determine the efficacy and safety of trocar–guided mesh kits.Methods
- A literature search and analysis was performed using Medline, PubMed, Cochrane database, current texts and references from relevant articles.
- Inconclusive evidence supporting conservative, mechanical and some surgical options for treating recurrent vault prolapse; including iliococcygeal fixation, McCall culdoplasty, and infracoccygeal sacropexy was found.
- Sacrospinous ligament fixation (SSLF), sacrocolpopexy, mesh implants and colpocleisis are shown to have good outcomes in Level II studies.
- Nevertheless, the first two are associated with haemorrhage, dyspareunia and scarring whilst colpocleisis is limited to selected patients.
- More well-designed studies are required for recurrent vault prolapse.