Bilateral anterior sacrospinous ligament suspension associated with a paravaginal repair with mesh: short-term clinical results of a pilot study

This study aims to assess anatomical and functional results of bilateral anterior sacrospinous ligament suspension associated with paravaginal repair with mesh. Forty-eight patients were operated between March 2007 and August 2008. Mean age was 67 years old. Nineteen patients (39.6%) had been previously operated for a genital prolapse. All patients had both anterior vaginal wall prolapse and a level 1 defect; stage 2 to 4 (POP-Q). Median follow-up is 8 months (range 1 to 18). Peri-operative complications were: one bladder injury (2.1%), three haematomas (6.3%), two ureteral kinking (4.2%) and two sciatic pain (4.2%). Anatomical success was observed in 47/48 patients (97.9%) for uterine or vaginal vault prolapse and 46/48 patients (95.8%) for anterior vaginal wall prolapse. This procedure is a challenging surgical technique requiring a significant level of skill and training, which yields a very high success rate; however, it is not without potential ureteral and neurologic complications.