Uncommon complications of sacrospinous fixation for treatment of vaginal vault prolapse

Abstract

The present study was undertaken to evaluate uncommon complications following transvaginal sacrospinous colpopexy for treatment of vaginal vault prolapse. A series of three patients who developed uncommon complications following sacrospinous fixation are reported. A 64-year-old patient undergoing bilateral sacrospinous colpopexy for the treatment of an ICS stage III vaginal vault prolapse developed a perineal necrotizing infection. Another patient, a 69-year-old woman with total vaginal vault prolapse and anterior vaginal wall defect (ICS stage II), underwent a right transvaginal sacrospinous colpopexy and anterior repair, presenting postoperatively with a perineal hernia. The third case consisted of a 71-year-old woman who underwent a right sacrospinous colpopexy with paravaginal repair, rectocele repair, and perineorrhaphy for treatment of an ICS stage III post-hysterectomy vaginal vault prolapse, stage II cystocele secondary to a bilateral paravaginal defect, and a stage II rectocele. Six months later the patient developed a left lateral enterocele, which was successfully repaired with a left sacrospinous ligament fixation. Etiological factors and treatment considerations for these uncommon complications of sacrospinous colpopexy are discussed in detail, and prophylactic measures, when applicable, are emphasized.