Vaginal hysterectomy and sacrospinous colpopexy for uterovaginal prolapse: anatomical and functional outcomes

ABSTRACT

The surgical management of pelvic organ prolapse requires a combination of techniques. This study evaluated the anatomical outcomes, functional outcomes and complications of vaginal hysterectomy and sacrospinous colpopexy in women with uterovaginal prolapse. We retrospectively evaluated 85 women who underwent vaginal hysterectomy and sacrospinous colpopexy over a period of 3 years. The primary outcome measures included anatomical outcome success rates [as assessed by pelvic organ prolapse quantification, POP-Q], pelvic floor function outcomes and complication rates. At a mean follow-up duration of 35 months [range 12-60], the overall objective success [for all compartments] was 81% [69/85], while the objective success rates for the anterior, posterior and apical compartments were 82% [70/85], 89% [76/85] and 92% [78/85]. Respectively, there were no stage 3 or 4 recurrences at any site. Overactive bladder [OAB] symptoms improved significantly following the surgery, while new-onset stress urinary incontinence occurred in 5 patients. There was no significant change in sexual activity or dyspareunia. Surgical complications were minor. The combination of vaginal hysterectomy and sacrospinous colpopexy for the treatment of uterovaginal prolapse is reasonably effective in restoring pelvic anatomy and results in favourable pelvic function with an acceptable complication rate