Bilateral attachment of the vaginal cuff to iliococcygeus fascia: an effective method of cuff suspension

Abstract

Objective: The objective of this study was to determine the anatomic success, defined as no persistent or recurrent support defects, of suspension of the vaginal cuff to iliococcygeus fascia.

Study design: Forty-two women treated by suspension of the vaginal cuff to iliococcygeus fascia and repair of coexisting pelvic support defects between March 19, 1987, and June 11, 1992, had site-specific analysis of pelvic support performed preoperatively and at consecutive postoperative visits. The findings at the 6-week postoperative visit and subsequent visits were compared for support of the vaginal cuff and additionally for the urethra, bladder, cul-de-sac, and rectum.

Results: Two patients (5%) have had recurrence of their cuff prolapse during follow-up, one of whom required further surgery. She also had recurrence of an inguinal hernia that had been repaired at the original surgery. The other patient who had had five previous pelvic procedures developed asymptomatic prolapse of the cuff halfway to the hymen. Six additional patients have had loss of support at other sites in the follow-up period, one of whom had repeat surgery.

Conclusion: Ninety-five percent of women experienced no persistence or recurrence of cuff prolapse 6 weeks to 5 years after the procedure.