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Ten years’ follow-up after iliococcygeus fixation for the treatment of apical vaginal prolapse

International Urogynecology Journal volume 32, pages 1533–1538 (2021)Cite this article

Abstract

Introduction and hypothesis

Various surgical techniques have been described for vaginal vault prolapse repair, but the best surgical approach is still to be proven. The aim of this study is to report the long-term objective and subjective outcomes of women who underwent iliococcygeus fixation for the treatment of vaginal vault prolapse with a minimum follow-up of 10 years.

Methods

Women with symptomatic vaginal vault prolapse (Pelvic Organ Prolapse Quantification [POP-Q] stage ≥ 2) who had previously undergone hysterectomy for any reason were prospectively enrolled and treated with iliococcygeus fixation. Subjective success was defined as Patient Global Impression of Improvement (PGI-I) ≤ 2 and an absence of bulging symptoms. Objective success was defined as stage of prolapse < 2 in all compartments. Overall success rate was defined as women without prolapse symptoms, PGI-I ≤ 2, stage of prolapse < 2, and no need for other surgery. Prolpase Quality of Life (P-QOL) questionnaires were completed at the preoperative visit and at every follow-up visit. Multiple logistic regression was performed to identify factors involved in the risk of recurrent POP.

Results

After a median (range) follow-up of 120 (120–132) months, the subjective, objective, and overall cure rates were 82% (32/39), 74.4% (29/39), and 74.4% (29/39), respectively. Only stage IV vault descensus independently predicted POP recurrence after ICG (OR: 7.66 [95% CI: 1.21–9.02]; p < 0.001).

Conclusion

Iliococcygeus fixation seems to be a safe and effective option for the treatment of vaginal vault prolapse at 10 years' follow-up.

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Acknowledgements

Members of the Italian Society of Urodynamics: Maurizio Serati: Executive Member; Scientific Chairman; Co-Chair of Scientific Committee. Andrea Braga: Executive Member; Member of Scientific Committee.

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Affiliations

  1. Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy

    Maurizio Serati, Chiara Scancarello & Fabio Ghezzi

  2. Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Stefano Salvatore

  3. First Department of Obstetrics and Gynecology, University of Athens, “Alexandra” Hospital, Athens, Greece

    Stavros Athanasiou

  4. Department of Obstetrics and Gynecology, EOC - Beata Vergine Hospital, Via Turconi 23 CP 1652, 6850, Mendrisio, Switzerland

    Andrea Braga

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  1. Maurizio Serati
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  2. Stefano Salvatore
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  3. Stavros Athanasiou
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  4. Chiara Scancarello
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  5. Fabio Ghezzi
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  6. Andrea Braga
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on behalf of the Italian Society of Urodynamics

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Correspondence to Andrea Braga.

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Serati, M., Salvatore, S., Athanasiou, S. et al. Ten years’ follow-up after iliococcygeus fixation for the treatment of apical vaginal prolapse. Int Urogynecol J 32, 1533–1538 (2021). https://doi.org/10.1007/s00192-020-04598-6

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  • DOI: https://doi.org/10.1007/s00192-020-04598-6

Keywords

  • Iliococcygeus fixation
  • Vaginal vault prolapse
  • Apical prolapse
  • Long term follow-up
  • Pelvic organ prolapse
  • Native tissue repair