Sacrocolpopexy for post hysterectomy vault prolapse: A single centre experience in south India

Abstract

Post hysterectomy vault prolapse is the protrusion of vagina through the genital hiatus and is sometimes accompanied by bowel and bladder symptoms. Sacrocolpopexy is considered as the gold standard for surgical management of vaginal vault prolapse. This procedure can be performed by abdominal, laparoscopic or robotic route. In this study we are presenting the analysis of all the cases of vault prolapse managed by abdominal or laparoscopic sacrocolpopexy in our hospital within a period of four years and its outcome until a follow up for one year.The majorities of the patients in our case series presented with a reducible vaginal mass and most of them had POP-Q stage III prolapse. Abdominal sacrocolpopexy and laparoscopic sacrocolpopexy was performed for seven and five cases respectively. Anatomic success rate was 100% and none of them had a recurrence of apical prolapse till one year of follow up. Immediate improvement of symptoms was observed in 86% and 100% of patients with ASC and LSC respectively; but at one year of follow up the functional improvement were retained in 57% and 80% for ASC and LSC respectively.Sacrocolpopexy is a reliable & effective procedure for management of vaginal vault prolapse. This procedure provides relief from the symptoms of prolapse along with providing good anatomical support and is helpful in preventing recurrence of the defect.