Functional outcome after sacrospinous hysteropexy for uterine descensus

The study aimed to evaluate urogenital symptoms, defecatory symptoms and quality of life before and after a sacrospinous hysteropexy for uterovaginal prolapse. Seventy-two women with symptomatic uterovaginal prolapse were treated with sacrospinous hysteropexy. Before and after surgery, urogenital and defecatory symptoms and quality of life were assessed with a validated questionnaire. Anatomical outcome was assessed by means of pelvic examination before and after surgery. The mean follow-up time was 12.7 months. Scores on all domains of urogenital symptoms and defecatory symptoms, except for the pain and fecal incontinence domain, improved significantly. Also, quality of life improved on all domains. No major complications were encountered

Magnetic resonance imaging findings following three different vaginal vault prolapse repair procedures: a randomised study

Objective: to compare the vaginal configuration on magnetic resonance imaging following transvaginal sacrospinous fixation (SSF), posterior intravaginal slingplasty (PIVS) (infracoccygeal sacropexy) and sacrocolpopexy (SCP).\ud \ud Materials and methods: twenty-one patients with vault prolapse requiring surgical treatment were randomly assigned in a balanced way to undergo SSF (n = 7), PIVS (n = 7) or SCP (n = 7). The magnetic resonance imaging of the pelvis were performed preoperatively and at 6–12 weeks postoperatively to assess the vaginal configuration using the method described previously. The two main angles measured were: (i) the angle between the lower vagina and pubococcygeal line 'd-angle' (normal: 53 ± 15°); and (ii) the angle between the lower and upper vagina planes 'e-angle' (normal: 145 ± 7°).\ud \ud Results: the mean preoperative/postoperatively measured d-angles were 69°/62°, 58°/70°, and 49°/52° for SSF, PIVS and SCP, respectively. The corresponding means for the e-angle were 173°/215°, 189°/146°, and 205°/149°. The changes of the e-angles proved to be statistically significant (P < 0.05) in each surgical group, while no significant change in the d-angle could be found in any of the three groups.\ud \ud Conclusions: significant improvements in the restoration of vaginal configuration were achieved in patients who underwent PIVS or SCP. Sacrospinous fixation in contrast seems to increase anatomical distortion of the vaginal configuration