Boztosun, Abdullah Cumhuriyet Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum Anabilim Dalı, Turkey , Yıldırım, Muradiye Cumhuriyet Üniversitesi - Tıp Fakültesi - Kadın Doğum Anabilim Dalı, Turkey , Akkar, Özlem Bozoklu Cumhuriyet Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum Anabilim Dalı, Turkey , Özsoy, Asker Zeki Gaziosmanpaşa Üniversitesi - Tıp Fakültesi - Kadın Doğum Anabilim Dalı, Turkey , Yenicesu, Gonca İmir Cumhuriyet Üniversitesi - Tıp Fakültesi - Kadın Doğum Anabilim Dalı, Turkey , Müderris, İptisam İpek Erciyes Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum Anabilim Dalı, Turkey , Yanık, Ali Cumhuriyet Üniversitesi - Tıp Fakültesi - Kadın Doğum Anabilim Dalı, Turkey

Results of sacropexy and sacrospinous ligament fixation in apical genital prolapses

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Aim. Evaluation of sacropexy and sacrospinous ligament fixation operations that are applied in the surgical treatment of the cases of apical genital prolapses. Methods. The records of 49 patients who are operated for uterine prolapse or vaginal cuff prolapse were analysed retrospectively. The results of all patients were evaluated, and then the patients are allocated in two groups namely as sacropexy (abdominal sacrocolpopexy/sacrocervicopexy) and sacrospinous ligament fixation groups. Additionaly, the outcomes of groups were compared with each other. The cases were investigated specifically in terms of postoperative complaints, urinary incontinence, operation satisfaction, and postoperative signs. Results. Mean follow-up periods were 41.2 months (41.2±24.9) in the sacropexy group, and 69.1 months (69.1±8.2) in the sacrospinous fixation group. There weren’t any cases of recurrent prolapse in the sacropexy group. Recurrence occured in two cases (11.1%) in the sacrospinous ligament fixation group. There were no significant differences in recurrence rates between the two groups (p=0.058). Although anterior and posterior repair was more frequently applied in sacrospinous fixation group than sacropexy group (83.3% vs. 38.7%; p=0.013), the rates of postoperatively detected cysto-rectocele were similar in both groups. While 93.5% of the patients in the sacropexy group were fully satisfied, and 6.5% of them were moderately satisfied and there were no unsatisfied patients. In the sacrospinous ligament fixation group there were 2 unsatisfied patients (11.1%). In terms of patient satisfaction there was significant difference between two groups (p=0.034). Conclusion. For cases of apical genital prolapse, sacropexy and sacrospinous ligament fixation operations are obviously promising. On the other hand, in terms of recurrence and patient satisfaction, sacropexy operations can be considered to be more promising. In addition, it can be said that sacropexy procedure can also reduce the need for the cystorectocele operation.

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Sacropexy , sacrocolpopexy , sacrocervicopexy , sacrospinous ligament fixation

Cumhuriyet Medical Journal

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