Sacrospinous Fixation for Vaginal Vault Prolapse: Anatomical and Functional Outcomes and Qualityof- Life Assessment

Abstract

Objectives: To evaluate long-term anatomical and functional outcomes and quality of life in women who had sacrospinous fixation for post-hysterectomy vaginal vault prolapse.
Methods: A retrospective study of patients who underwent sacrospinous fixation for post-hysterectomy vaginal vault prolapse from June 2004 to August 2010 at the United Christian Hospital, Hong Kong, was conducted. Prolapse was assessed by using the Pelvic Organ Prolapse Quantification system; details of symptoms were collected at follow-up. Quality of life was assessed with the Pelvic Floor Distress Inventory–20 and the Pelvic Floor Impact Questionnaire–7.
Results: During the study period, 28 patients were identified. The overall success rate of sacrospinous fixation was 89.3% (vaginal vault prolapse of stage I or no prolapse) with a mean follow-up of 39 months (range, 9-70 months). Recurrence of cystocele and rectocele occurred in 47.6% and 16.7% of patients, respectively. Urinary and bowel symptoms were improved following surgery. The complication rate was low and complications were managed conservatively. The mean scores for the Pelvic Floor Distress Inventory–20 and the Pelvic Floor Impact Questionnaire–7 were 21 of 300 and 5 of 300, respectively.
Conclusion: This study suggests that sacrospinous fixation is an effective and durable operation for vaginal vault prolapse, and with low morbidity.