Sacrospinous vault suspension and abdominal colposacropexy: success rates and complications.

Abstract

Our purpose was to compare success rates and complications of sacrospinous vault suspension and abdominal colposacropexy. A case series is presented of 130 attempted sacrospinous vault suspensions with the Miya hook and 80 cases of abdominal colposacropexy, done in conjunction with other procedures. Patients were assessed 6 weeks and 6 and 12 months after surgery and yearly thereafter. Sacrospinous vault suspension was completed in 125 women (5 abandoned because of technical difficulty). Abdominal colposacropexy was completed in all 80 women. There was only one intraoperative complication-hemorrhage from the presacral veins during abdominal colposacroplexy. The incidence of postoperative febrile morbidity was 10% after sacrospinous vault suspension and 6% after abdominal colposacropexy. Follow-up ranged from 6 months to 5 years. The incidence of recurrent vault prolapse was 2.4% with sacrospinous vault suspension and 1.3% with abdominal colposacropexy. Demonstrable stress urinary incontinence occurred in one woman after abdominal colposacropexy and in none after sacrospinous vault suspension. Sacrospinous vault suspension and abdominal colposacropexy are associated with a low incidence of intraoperative and postoperative complications and recurrent vault prolapse. Latent stress urinary incontinence may be unmasked, particularly with abdominal colposacropexy, and preoperative urodynamic evaluation is therefore recommended.