Anterior vaginal mesh sacrospinous hysteropexy and posterior fascial plication for anterior compartment dominated uterovaginal prolapse

Abstract

The surgical management of multi-compartment prolapse is challenging and often requires a combination of techniques. This study evaluates anterior vaginal mesh repair, sacrospinous hysteropexy and posterior fascial plication in women with anterior compartment dominated uterovaginal prolapse. Consecutive women who underwent the aforementioned surgery were prospectively evaluated. Main outcome measures included objective (pelvic organ prolapse quantification stage <2) and subjective success rates, patient satisfaction, functional outcomes and complications. One hundred and seventeen women were eligible, and 100 agreed to participate. At 12 months, objective success rate at the anterior compartment was 87% and at all compartments, 75%. Subjective success was 84%, and mean patient satisfaction was 8.5/10. There were no stage 3 or 4 recurrences at any site. The combination of anterior vaginal mesh, sacrospinous hysteropexy and posterior fascial plication is reasonably effective in restoring the anatomy and achieving favourable bladder, bowel and sexual function.