Long-Term Outcomes (10 Years) of Sacrospinous Ligament Fixation for Pelvic Organ Prolapse Repair

被引:1
作者
Vigna, Annalisa [1 ]
Barba, Marta [2 ]
Frigerio, Matteo [2 ]
机构
[1] Univ Genoa, IRCCS Policlin San Martino, Dept Gynecol, I-16126 Genoa, Italy
[2] Univ Milano Bicocca, IRCCS San Gerardo Tintori, Dept Gynecol, I-20900 Monza, Italy
关键词
post-hysterectomy vault prolapse; native-tissue repair; high uterosacral ligament suspension; sacrospinous ligament fixation; transvaginal repair; pelvic organ prolapse; MODIFIED MCCALL CULDOPLASTY; VAGINAL VAULT PROLAPSE; SURGICAL-MANAGEMENT; UTERINE PROLAPSE; SUPPORT DEFECTS; SUSPENSION; HYSTEROPEXY; ANTERIOR; HYSTERECTOMY; SACROCOLPOPEXY;
D O I
10.3390/healthcare12161611
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Vaginal vault prolapse is one of the main reasons for reoperation in patients with pelvic organ prolapse. Effective correction of the vaginal apex is essential for lasting repair for these women. Apical suspension of the sacrospinous ligament is probably one of the main vaginal treatments still offered to patients today. We proposed an evaluation of the functional and anatomical results of long-term sacrospinous ligament fixation. Objective: The purpose of this study was to evaluate the 10-year results of sacrospinous ligament suspension as primary repair for apical prolapse and to evaluate long-term side effects. Materials and Methods: A retrospective study analyzed 10-year follow-up after prolapse repair using sacrospinous ligament suspension. A subjective recurrence was identified as the postoperative occurrence of swelling symptoms based on a particular item on the Italian Prolapse Quality of Life (P-QoL) questionnaire. An objective recurrence was defined as a postoperative decline to stage II or below in any compartment based on the POP-Q system or the requirement for additional surgery. The assessment of postoperative subjective satisfaction was conducted using the Patient Global Impression of Improvement (PGI-I) score. Results: In total, 40 patients underwent sacrospinous ligament fixation. Objective recurrence was remarkably high, as it was observed in 17 (56.7%) patients. Subjective recurrence was reported by ten (33.3%) women, and reintervention occurred in two (6.7%) of patients. From the point of view of quality of life, according to the PGI-I, twenty-three (76.7%) patients described some degree of improvement after surgery, four (13.3%) described their status as unmodified, and three (10%) reported some form of worsening after primary treatment. Conclusions: Transvaginal repair with sacrospinous fixation is a long-lasting option for prolapse repair, with improvement in every POP-q parameter. Some degree of anterior recurrence, recurrence of symptoms with swelling, or an overall worsening of quality of life after surgery is possible.
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页数:10
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