Non-Oral Poster 46

Abstract

OBJECTIVES: To determine if a sacrospinous ligament fixation compared to uterosacral ligament suspension affects the outcome of anterior vaginal wall repair. MATERIALS AND METHODS: A cohort study comparing the outcome of anterior vaginal wall in women undergoing anterior repair with sacrospinous ligament fixation versus uterosacral suspension. This study was conducted at Jackson Memorial Hospital between January 2000 and October 2008. Patients with other types of apical suspension, no apical suspension or incomplete data sets were initially excluded, thus leaving 117 patients for evaluation. Patients were divided into two groups; Anterior repair with sacrospinous ligament fixation 58(49.6%) and Anterior repair with uterosacral suspension 59(50.4%). All the patients underwent standardized preoperative work up and urodynamics. Pelvic organ prolapse was assessed utilizing the ICS Pelvic Organ Prolapse Quantification System (POP-Q) on preoperative and post operative visits. Data was analyzed using t-test for independent samples, Fischer exact test and Chi square test. RESULTS: There was no significant difference in parity [median (range), 3(0–9) vs. 3(0–11] or BMI (mean ± SD, 27.7 ± 4.2 vs. 27.3 ± 3.8) in the two groups. Patients in the sacrospinous group were older in age (mean ± SD, 62.2 ± 8.4 vs. 56.3 ± 10.7, P 0.001). All patients were followed for at least 1 month and underwent a POP-Q exam on each of the postoperative visits. There was no significant difference in the rate of failure of the anterior vaginal wall amongst patients undergoing a sacrospinous ligament fixation 13.8%(n = 8) compared to uterosacral ligament suspension 16.97%(n = 10), P = 0.8. CONCLUSION: Sacrospinous ligament fixation as compared to uterosacral ligament suspension does not appear to negatively affect the outcome of the anterior vaginal wall repair.