Long-term Patient Satisfaction and Function After Sacrocolpopexy for Vault Prolapse Repair

Abstract

In Brief Objective: To report the longer term efficacy of sacrocolpopexy (SCP). Efficacy will be assessed in terms of alleviation of prolapse symptoms, reoperations in the follow-up, and patient satisfaction. To report any change in bladder, bowel, and sexual function after the operation. Design: Retrospective case notes review and telephone interview survey. Setting: A Teaching Hospital (Addenbrooke's Hospital, Cambridge, UK). Population: All women who underwent SCP (n = 68) for symptomatic vault prolapse grade 2 or above, between January 1992 and December 2002. Methods: Case notes were reviewed for demographic details, stage of prolapse, and the functional symptoms related to bladder, bowel, and sexual function preoperatively. Any perioperative complications were noted. Detailed telephone interviews were conducted during August 2004 to assess whether there was recurrence of prolapse symptoms, whether there was any change in bladder, bowel, and sexual function, and to determine overall satisfaction. Results: Perioperative complication rate was low. Excluding patients who were deceased, 90% women were contactable for detailed interviews. Thirteen percent reported a recurrence of prolapse symptoms in SCP series (mean follow-up 55 months) and 3% had reoperations for vault prolapse. Patients reported improvement in urinary urgency, hesitancy, and stress incontinence, and some deterioration in bowel function, mainly constipation (23%). Patient satisfaction rate was 80%. Approximately half of the dissatisfied patients stated that deterioration in pelvic function was their main reason for discontent. Conclusion: SCP is effective in the longer term and appears to have some beneficial effect on bladder function. This article reports long-term follow-up of sacrocolpopexy for symptomatic vault prolapse repair, assessing patient satisfaction and function, showing 80% satisfaction rate, 13% recurrence of prolapse symptoms, some improvement in bladder function, and some deterioration in bowel function.