Sacrospinous fixation for vaginal vault prolapse after hysterectomy sec. Miyazaki – longterm results

Czech version

Authors: R. Pilka; Milan Kudela ; P. Hejtmánek; P. Dzvinčuk
Authors‘ workplace: Porodnicko-gynekologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D.
Published in: Ceska Gynekol 2013; 78(1): 27-31

Overview

Objective:
To assess intra- and postoperative complications and to look for long term follow-up results in women with sacrospinous ligament fixation for vaginal vault prolapse sec. Miyazaki.

Design:
Retrospective study.

Setting:
Department of Obstetrics and Gynecology, University Hospital, Olomouc.

Methods:
Between January 2002 and December 2011,112 women (mean age 66.8, range 44 to 88 years) underwent vaginal unilateral sacrospinous ligament fixation sec. Miyazaki; 101 patients had prior hysterectomy. In 11 patients concomitant hysterectomy and sacrospinous ligament fixation was performed.

Results:
All 112 patients were analysed for intra and postoperative complications. Urinary tract infection (n=6; 5.3%), hematoma (n=6; 5.3%), temporary urinary retention (n=3; 2.7%), and temporary irritation of the static nerve (n=2; 1.6%), occurred in the postoperative phase. Long term data (range from 1 month to 8 years, mean 22 months) exist for 59 patients. 56 were completely cured without any signs of urinary inkontinence and prolapse. At follow-up 3 patients (5.1%) showed recurrent vaginal vault prolapse. Recurrent cystoceles and rectoceles were found in 10 (16.9%) and one (1.6%) cases respectively. Three patiens with complete recurrence of vaginal vault prolapse successfully underwent repeated sacrospinous ligament fixation sec. Miyazaki (2 cases) or polypropylene mesh insertion (1 case).

Conclusion:
Sacrospinous ligament fixation sec. Miyazaki is an effective and safe procedure with a low recurrence and complication rate.

Keywords:
acrospinous ligament fixation – vaginal vault prolapse – complications – Miyazaki

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