Vaginal sacrocolporectopexy for the surgical treatment of uterine and vaginal vault prolapses: confirmation of the surgical method and perioperative results of 101 cases
Archives of Gynecology and Obstetrics, 08/08/2012
Hertel H et al. – This study soughts to confirm the surgical method of vaginal sacrocolporectopexy and previously reported positive perioperative results of this procedure in a large patient group. Thestudy describes the approach which offers a vaginal, safe alternative to sacrospinous repair, laparoscopic or open vaginosacropexy and the use of synthetic meshes to treat pelvic organ prolapse. It was seen that vaginal sacrocolporectopexy is a safe vaginal method for the treatment of sub–/total uterine/vaginal vault prolapse.Methods
- A monocentric, prospective, nonrandomized study for treatment of patients with uterine and vaginal vault relapse (grade 2–4) was conducted. All patients underwent a preoperative urogynecological urodynamic examination.
- All patients underwent a preoperative urogynecological urodynamic examination
- Method, operative time, complications, blood transfusions, hospital stay and clinical data were described in detail
- Between March 2006 and March 2011, 101 consecutive patients of mean age 64 (40–89) years, with sub or total uterine prolapse (n = 69, grade 2–4) and vaginal vault prolapse (n = 32, grade 2–4) were treated with vaginal sacrocolporectopexy.
- Cystocele (grade 2–4) was found in 88 (87.1 %) and rectocele (grade 2–4) in 43 (42.5 %) patients.
- Mean duration of surgery with sacrocolporectopexy was 70 min (28–165) without hysterectomy, and 76 min (40–219) with hysterectomy.
- Regression analysis of all patients (n = 101) showed a significant decrease of operative time in the group without hysterectomy after 40 cases.
- Three bladder lesions, two in patients with a history of hysterectomy, occurred during surgery and were corrected intraoperatively without further complications.
- No patient required a blood transfusion. Hemoglobin levels decreased slightly from a preoperative mean of 13.6 mg/dl (10.3–15.7) to a postoperative mean of 11.7 mg/dl (8.6–14.7).