Document Detail


Iliococcygeus fixation or abdominal sacral colpopexy for the treatment of vaginal vault prolapse: a retrospective cohort study.
MedLine Citation:
PMID:  24030216     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION AND HYPOTHESIS: To compare the efficacy and safety of iliococcygeus fixation (ICG) and abdominal sacral colpopexy (SCP) in the treatment of vaginal vault prolapse.
METHODS: Patients with symptomatic vaginal vault prolapse after hysterectomy were considered in this analysis. Surgical outcomes, i.e., the capacity to restore the anatomy of the vaginal cuff and improvement in the prolapse-related symptoms were compared. Continuous variables were compared using the Student's t test, while non-continuous variables using a Chi-squared test or Fisher's exact test.
RESULTS: Sacrocolpopexy was performed in 41 patients, while ICG fixation was carried out in 36 patients. Operative time was significantly shorter (78 vs 140 min, p < 0.001) and median blood loss higher in the ICG group (150 ml vs 100 ml, p=0.01). The rates of postoperative complications of the two groups were not statistically different. Relapse rate was similar in the two groups (15 % in the SCP and 22 % in the ICG group respectively, p=0.36). Considering the POP-Q score, both SCP and ICG achieved a significant and comparable correction of vaginal prolapse. The evaluation of postoperative subjective symptoms revealed a significant improvement in voiding and vaginal bulging related to pelvic organ prolapse in both groups.
CONCLUSIONS: Both ICG fixation and SCP are effective in restoring normal anatomy in patients with vaginal vault prolapse and in relieving associated symptoms. Owing to its lower morbidity and to the advantage of not using a synthetic device, ICG might be an excellent option for the treatment of recurrent vaginal vault prolapse following hysterectomy.
Authors:
Rodolfo Milani; Maria Cristina Cesana; Federico Spelzini; Martina Sicuri; Stefano Manodoro; Robert Fruscio
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-13
Journal Detail:
Title:  International urogynecology journal     Volume:  -     ISSN:  1433-3023     ISO Abbreviation:  Int Urogynecol J     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101567041     Medline TA:  Int Urogynecol J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, San Gerardo Hospital, Via Pergolesi 33, Monza, Italy.
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