Abdominal techniques for surgical management of vaginal vault prolapse

ABSTRACT

To evaluate and compare the short and long term safety and effectiveness of different abdominal techniques for surgical management of vaginal vault prolapse. Observational Cross sectional study. Department of Obstetrics and Gynaecology Unit II, Bahawal Victoria Hospital, Bahawalpur, from January 2001 to December 2008. A total of 80 cases were divided into four Groups [20 patients in each]. In Group A, patients were managed by sacrocolpolexy with polypropylene [Prolene mesh, Group B had sacrocolpopexy with autologous rectus sheath, Group C underwent high uterosacral ligament suspension and Group D had vault suspension with an autologous fascial sling of rectus shealth.. All cases were analyzed regarding their complaints, clinical examination, investigations and follow up. No recurrence occurred in group A, as compared to 10%, 20% and 15% in Group B, C and D respectively. No patient from Group A reported with incisional hernia as compared to 10%, 5% and 10% in Group B, C and D. Operative time was less in Group A as compared to Group B but longer as compared to Group D and almost same as in Group C. The complaint of low persistent backache remained same in Group A and B [30%] as compared to 35% in Group C and D. Least blood loss was observed in Group A. Sacrocolpopexy is gold standard procedure for treatment of vault prolapse. If it is performed with prolene mesh best results are expected