E-Posters-Size of the Genital Hiatus as a Predictor for Recurrence of Vaginal Prolapse Following Sacrospinous Ligament Fixation -

Size of the Genital Hiatus as a Predictor for Recurrence of Vaginal Prolapse Following Sacrospinous Ligament Fixation - - Alexandra N Garcia, MD

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This study aimed to determine if a wide genital hiatus (GH) before sacrospinous ligament fixation (SSLF) surgery is a predictor of vaginal wall prolapse recurrence. The researchers conducted a retrospective chart review of patients who underwent SSLF for vaginal vault prolapse at a single institution between August 2010 and May 2016.<br /><br />The patients were divided into two groups: those with a normal genital hiatus (NGH) and those with a wide genital hiatus (WGH). The size of the genital hiatus was defined as less than 4cm for NGH and 4cm or greater for WGH. Recurrence was defined as any prolapse to or beyond the hymen.<br /><br />The study found that patients in the WGH group had more significant prolapse preoperatively compared to the NGH group. The WGH group also had significantly more preoperative stage 4 prolapse. Postoperatively, stage 0 was more common in the NGH group, while stages 1-4 combined were more common in the WGH group. There was significantly more prolapse in the anterior compartment in the WGH group.<br /><br />Operative time and estimated blood loss were significantly greater in the WGH group. The recurrence rate was significantly higher in the WGH group compared to the NGH group, with five recurrences in the anterior compartment and one in the posterior compartment.<br /><br />The study has limitations, including its retrospective design, small sample size, and inherent bias in the assessment of prolapse. However, the strengths of the study include all subjects derived from a single institution and examined by the same observer.<br /><br />In conclusion, this study suggests that a preoperative wide genital hiatus may be a predictor of vaginal wall prolapse recurrence following SSLF. Further research is needed to confirm these findings and explore potential strategies for reducing the risk of recurrence in patients with a wide genital hiatus.

Keywords

wide genital hiatus

sacrospinous ligament fixation

vaginal wall prolapse recurrence

retrospective chart review

single institution

genital hiatus size

prolapse recurrence

preoperative prolapse stage

operative time

estimated blood loss