Skip to main content

Advertisement

Log in

Risk factors of surgical failure following sacrospinous colpopexy for the treatment of uterovaginal prolapse

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Trans-vaginal sacrospinous colpopexy is one of the surgical procedures used to repair varying degrees of vaginal vault and uterovaginal prolapse. The purpose of this study is to analyse the potential risk factors of surgical failure following sacrospinous colpopexy.

Methods

A retrospective study of 114 women who underwent unilateral sacrospinous colpopexy at Jordan University Hospital from January 2005 to January 2008 were included. Patient demographics, clinical characteristics and concomitant pelvic organ prolapse surgery were assessed. The patients were evaluated at 6 weeks, and every 6 months thereafter. Twelve (11 %) had recurrent apical (vaginal cuff) prolapse, 26 (23 %) had recurrent prolapse at any compartment were compared with those who had successful surgery. Univariate and logistic regression analyses were used to assess the independent prognostic values of the variables associated with surgical failure.

Results

After a mean follow-up of 40 months, the statistically significant predictors of surgical failure included the presence of advanced pre-operative stages of prolapse (stages III and IV), the more distally located points Ba, Bp and C and a lack of mesh augmentation of the anterior vaginal wall during surgery (P = 0.01, 0.027, 0.024, 0.034 and 0.006, respectively). However, a history of prior vaginal repair, the more distally located point Ba and a lack of anterior vaginal wall mesh augmentation were defined as independent predictive variables based on logistic regression analyses (P = 0.04, 0.005 and 0.046, respectively).

Conclusions

The presence of advanced anterior vaginal wall prolapse, prior vaginal repair and a lack of mesh augmentation of the anterior compartment are significant risk factors for the surgical failure of sacrospinous suspension surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Samuelsson EC, Victor FT, Tibblin G, Svardsudd KF (1999) Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 180:299–305

    Article  PubMed  CAS  Google Scholar 

  2. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    Article  PubMed  CAS  Google Scholar 

  3. Randall CL, Nichols DH (1971) Surgical treatment of vaginal eversion. Obstet Gynecol 38:327–332

    PubMed  CAS  Google Scholar 

  4. Sze EHM, Karram MM (1997) Transvaginal repair of vault prolapse: a review. Obstet Gynecol 89:466–475

    Article  PubMed  CAS  Google Scholar 

  5. Nichols DH (1982) Sacrospinous fixation for massive eversion of the vagina. Am J Obstet Gynecol 142:901–904

    PubMed  CAS  Google Scholar 

  6. Morley GW, De Lancey JO (1988) Sacrospinous ligament fixation for eversion of the vagina. Am J Obstet Gynecol 158:872–879

    PubMed  CAS  Google Scholar 

  7. Richter K, Albrich W (1981) Long term results following fixation of the vagina on the sacrospinal ligament by the vaginal route (vaginaefixatio sacrospinalis vaginalis). Am J Obstet Gynecol 141:811–816

    PubMed  CAS  Google Scholar 

  8. Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  PubMed  CAS  Google Scholar 

  9. de Tayrac R, Gervaise A, Chauveaud A, Fernandez H (2005) Tension-free polypropylene mesh for vaginal repair of anterior vaginal wall prolapse. J Reprod Med 50(2):75–80

    PubMed  Google Scholar 

  10. Miyazaki FS (1987) Miya Hook ligature carrier for sacrospinous ligament suspension. Obstet Gynecol 70:286–288

    PubMed  CAS  Google Scholar 

  11. Maher CF, Qatawneh AM, Baessler K, Schluter PJ (2004) Midline rectovaginal fascial plication for repair of rectocele and obstructed defecation. Obstet Gynecol 104:685–689

    Article  PubMed  Google Scholar 

  12. Paraiso MF, Ballard LA, Walters MD, Lee JC, Mitchinson AR (1996) Pelvic support defects defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol 175:1423–1430

    Article  PubMed  CAS  Google Scholar 

  13. Maher CF, Murray CJ, Carey MP, Dwyer PL, Ugoni AM (2001) Iliococcygeus or sacrospinous fixation for vaginal vault prolapse. Am J Obstet Gynecol 98:40–44

    Article  CAS  Google Scholar 

  14. Hoffman MS, Harris MS, Bouis PJ (1996) Sacrospinous colpopexy in the management of uterovaginal prolapse. J Reprod Med 41:299–303

    PubMed  CAS  Google Scholar 

  15. Holley RL, Varner RE, Gleason BP, Apffel LA, Scott S (1995) Recurrent pelvic support defects after sacrospinous ligament fixation for vaginal vault prolapse. J Am Coll Surg 180:444–448

    PubMed  CAS  Google Scholar 

  16. Heinonen PK (1992) Transvaginal sacrospinous colpopexy for vaginal vault and complete genital prolapse in aged women. Acta Obstet Gynecol Scand 71:377–381

    Article  PubMed  CAS  Google Scholar 

  17. Nieminen K, Huhtala H, Heinonen P (2003) Anatomic and functional assessment and risk factors of recurrent prolapse after vaginal sacrospinous fixation. Acta Obstet Gynecol Scand 82:471–478

    Article  PubMed  Google Scholar 

  18. Whiteside J, Weber A, Meyn LA, Walters MD (2004) Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 191:1533–1538

    Article  PubMed  Google Scholar 

  19. Diez-Itza I, Azipitarte I, Beccerro A (2007) Risk factors for the recurrence of pelvic organ prolapse after vaginal surgery: a review at 5 years after surgery. Int Urogynecol J Pelvic Floor Dysfunct 18:1317–1324

    Article  PubMed  CAS  Google Scholar 

  20. Lin TY, Su TH, Wang YL, Lee MY, Hsieh CH, Wang KG, Chen GD (2005) Risk factors for failure of transvaginal sacrospinous uterine suspension in the treatment of uterovaginal prolapse. J Formos Med Assoc 104(4):249–253

    PubMed  Google Scholar 

  21. Chen H-Y, Chiu T-H, Ho M, Hung Y-C (2009) Analysis of risk factors associated with surgical failure of sacrospinous suspension for uterine or vaginal vault prolapse. Int Urogynecol J Pelvic Floor Dysfunct 20:387–391

    Article  PubMed  Google Scholar 

  22. Benson JT, Lucente V, McClellan E (1996) Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1421

    Article  PubMed  CAS  Google Scholar 

  23. Maher CF, Qatawneh A, Dwyer PL, Carey MP, Cornish A, Schluter P (2004) Abdominal sacral colpopexy for vaginal vault prolapse. A prospective randomized trial. Am J Obstet Gynecol 190:20–26

    Article  PubMed  Google Scholar 

  24. Maher C, Baessler K, Glazener MC, Adams EJ, Hagen S (2007) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 18:CD004014

    Google Scholar 

  25. Tsia-Shu L, Kiran A (2011) Combined anterior trans-obturator mesh and sacrospinous ligament fixation in women with severe prolapse—a case series of 30 months follow-up. Int Urogynecol J Pelvic Floor Dysfunct 22:299–306

    Google Scholar 

  26. Clark A, Gregory T, Smith V, Edwards R (2003) Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 189:1261–1267

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Jordan University Hospital for supporting this research.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ayman Qatawneh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Qatawneh, A., Thekrallah, F., Bata, M. et al. Risk factors of surgical failure following sacrospinous colpopexy for the treatment of uterovaginal prolapse. Arch Gynecol Obstet 287, 1159–1165 (2013). https://doi.org/10.1007/s00404-012-2685-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-012-2685-8

Keywords

Navigation