Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction
- PMID: 8987920
- DOI: 10.1016/s0002-9378(96)70085-6
Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction
Abstract
Objective: Our purpose was to evaluate the efficacy and consequences of sacrospinous ligament suspension and pelvic reconstruction.
Study design: Patients who underwent sacrospinous ligament suspension between 1978 and 1991 were evaluated from follow-up visits, telephone interviews, questionnaires, and chart reviews. Before and after operation, vaginal support was graded in three segments. Postoperative visceral and sexual function was evaluated.
Results: Mean length of follow-up for 243 patients was 73.6 months. Of these, 102 (42.0%) had a support defect in at least one segment; anterior, posterior, and apical defects were found in 91 (37.4%), 33 (13.6%), and 20 (8.2%) patients, respectively. A clinically significant defect was defined as a symptomatic first-degree or any second-or third-degree prolapse. Defect-free survival rates at 1, 5, and 10 years were 88.3%, 79.7%, and 51.9%, respectively. Eleven patients (4.5%) underwent subsequent pelvic reconstruction.
Conclusion: Sacrospinous ligament suspension and pelvic reconstruction are effective for vaginal apex support, but vaginal prolapse recurs with time, most commonly in the anterior segment.
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