Anterior Bilateral Sacrospinous Ligament Fixation: A Safe Route for Apical Repair
| Autor: | Ellen R. Solomon, Keisha Jones Md, Peter St. Marie, Oz Harmanli |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Blood transfusion Urology medicine.medical_treatment Urinary system Pelvic Organ Prolapse medicine.ligament Hysterectomy Vaginal Humans Medicine Prospective Studies Aged Fixation (histology) Ligaments business.industry Sacrospinous ligament Obstetrics and Gynecology Perioperative Middle Aged Surgery Dissection Concomitant Cohort Female business |
| Zdroj: | Female Pelvic Medicine & Reconstructive Surgery. 26:e33-e36 |
| ISSN: | 2151-8378 |
| DOI: | 10.1097/spv.0000000000000857 |
| Popis: | Objectives Traditionally, sacrospinous ligament fixation is performed unilaterally with a posterior dissection for correction of apical vaginal prolapse. There is limited information on alternative techniques including bilateral application and use of anterior vaginal dissection for this procedure. The objective of this study is to evaluate the anatomic and perioperative outcomes in women who have undergone bilateral sacrospinous ligament fixation through an anterior approach. Methods This cohort represents women in our prospective repository who underwent anterior approach bilateral sacrospinous ligament fixation between September 2011 and June 2014. Concomitant procedures were performed as indicated. Pelvic organ prolapse quantification points were measured preoperatively and at 6 weeks and 6 months postoperatively and were compared. Perioperative outcome measures and adverse events were also analyzed. Results In this cohort, 144 women underwent anterior approach to bilateral sacrospinous ligament fixation. The patients' mean age was 57.8 ± 10.9 years, and the average body mass index was 29.6 ± 5.8 kg/m. In patients who underwent anterior approach bilateral sacrospinous ligament fixation, points Aa, Ba, C, Gh, Ap, and Bp remained at stage I or less when compared with pelvic organ prolapse quantification measurements at the baseline. Perioperative and postoperative complications were minimal, with 1 (0.7%) patient requiring a blood transfusion and 3 (2%) patients suffered from intraoperative lower urinary tract injuries, none of which were attributable to the sacrospinous fixation part of the procedure. Conclusions Anterior approach bilateral sacrospinous ligament fixation is a safe and effective procedure for reestablishing apical support in a patient with apical vaginal prolapse. |
| Databáze: | OpenAIRE |
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