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Outcomes of Uterosacral Ligament Suspension of Vag ...
Outcomes of Uterosacral Ligament Suspension of Vaginal Vault Prolapse Post Hysterectomy - Michael O Carey, MB, BCh, BAO
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Vaginal vault prolapse, the descent of the vaginal apex after hysterectomy, is a challenging problem for surgeons. This study aimed to evaluate the complications and post-operative results of uterosacral vault suspension as a treatment for vaginal vault prolapse. A retrospective chart review was conducted on women who had this procedure over a five-year period. The mean preoperative POPQ point C, which measures the degree of prolapse, was +2.91. 96% of women had uterosacral vault suspension along with anterior and posterior repair, while 4% had only the suspension. There were no complications related to the bladder, ureter, or bowel, and no infections or hematomas. Only one woman required re-catheterization and one woman needed intermittent self-catheterization on discharge. At the 6-week follow-up, the mean POPQ point C was -6.57, indicating a significant improvement. None of the women reported recurrence of pelvic organ prolapse symptoms, urinary symptoms, or sexual dysfunction. Two women reported constipation and one had mild perineal pain. Uterosacral ligament vault suspension is considered a safe and effective option for treating vaginal vault prolapse. However, longer-term follow-up studies are needed. The use of mesh in these surgeries remains a concern for patients, highlighting the importance of alternative procedures like uterosacral vault suspension. In summary, this study found that uterosacral vault suspension had good short-term outcomes with minimal complications, offering a viable treatment option for vaginal vault prolapse.
Keywords
vaginal vault prolapse
hysterectomy
uterosacral vault suspension
complications
POPQ point C
retrospective chart review
short-term outcomes
alternative procedures
treatment option
pelvic organ prolapse symptoms
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