Technik der vaginalen sakrospinalen Fixation und Stellenwert im Vergleich zur Sakrokolpopexie und der vaginalen Netzeinlage

Abstract

PURPOSE: Aim of the study was to examine the application and technique of vaginal sacrospinous ligament fixation (SLF) in the treatment of middle compartment defects compared to abdominal or laparoscopic sacrocolpopexy and vaginal repair with meshes among urogynaecological specialists in German-speaking countries. MATERIAL AND METHODS: An anonymised questionnaire was sent to all members of the AGUB requesting information about the number of surgical procedures performed for prolapse repair, the technique of SLF and its application in the differential treatment of women with prolapse in a defined clinical situation. RESULTS: A total of 212 members replied. On average, 35 SLF, 28 vaginal meshes, 10 abdominal and 7 laparoscopic sacrocolpopexies and 5 other operations were carried out to treat middle compartment defects. Departments with a high level of laparoscopic expertise performed significantly more laparoscopic sacrocolpopexies. SLF is most often performed unilaterally using late-absorbable sutures. The vagina is predominantly fixated subepithelially and knotted tightly on the sacrospinous ligament. Most surgeons prefer SLF in elderly patients. CONCLUSIONS: SLF with modifications is the preferred method of treatment for middle compartment prolapse. Surgeon with a lot of endoscopic experience carry out laparoscopic sacrocolpopexy procedures more often.