Transvaginal Bilateral Sacrospinous Fixation after Second Recurrence of Vaginal Vault Prolapse: Efficacy and Impact on Quality of Life and Sexuality.

Salvatore Giovanni Vitale,Antonio Simone Laganà,Marco Noventa,Pierluigi Giampaolino,Brunella Zizolfi,Giuseppe Gullo,Salvatore Butticè,Valentina Lucia La Rosa,Diego Rossetti

doi:10.1155/2018/5727165

Abstract

Objective Our aim was to study the efficacy of transvaginal bilateral sacrospinous fixation (TBSF) and its impact on quality of life (QoL) and sexual functions in women affected by second recurrences of vaginal vault prolapse (VVP). Materials and Methods We performed a prospective observational study on 20 sexually active patients affected by second recurrence of VVP, previously treated with monolateral sacrospinous fixation. TBSF was performed in all the patients. They had been evaluated before the surgery and at 12-month follow-up through pelvic organ prolapse quantification (POP-Q) system, Short Form-36 (SF-36), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Results At 12-month follow-up, 18 out of 20 (90%) patients were cured of their recurrent VVP. No major intra- and postoperative complications occurred. We found a significant improvement in 4/5 POP-Q landmarks (excluding total vaginal length), SF-36, and PISQ-12 scores. Conclusion According to our data analysis, TBSF appears to be safe, effective, and able to improve both QoL and sexual functions in patients affected by second recurrence of VVP after previous monolateral sacrospinous fixation.

Highlights

Second recurrence of vaginal vault prolapse (VVP) is defined as prolapse of the vaginal vault or upper vagina after two previous reconstructive surgeries; this occurs when the top of the vagina descends below a point that is 2 cm less than the total vaginal length above the plane of the hymen [1]
Our aim was to study the efficacy of transvaginal bilateral sacrospinous fixation (TBSF) and its impact on quality of life (QoL) and sexual functions in women affected by second recurrences of vaginal vault prolapse (VVP)
We found a significant improvement in 4/5 prolapse quantification (POP-Q) landmarks, Short Form-36 (SF-36), and Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) scores

Summary

Introduction

Second recurrence of vaginal vault prolapse (VVP) is defined as prolapse of the vaginal vault or upper vagina after two previous reconstructive surgeries; this occurs when the top of the vagina descends below a point that is 2 cm less than the total vaginal length above the plane of the hymen [1]. The two most accepted surgical techniques for primary VPP are laparoscopic sacrocolpopexy (LSC) and sacrospinous fixation (SF) [4]. No randomized controlled trials have been published comparing the efficacy of the two treatments; LSC seems to be correlated to a lower recurrence rate of VVP and less dyspareunia; SF is associated with a shorter operation time, lower costs, and an earlier return to daily activities [5].

Methods

Results

Conclusion