INTRODUCTION AND HYPOTHESIS: Sacrocolpopexy is considered the gold standard treatment for vaginal vault prolapse.
However, the vaginal approach is very common, with 80-90 % of procedures being performed via this route. The aim of this study was to evaluate the safety and efficacy of iliococcygeus (ICG) fixation in the treatment of vaginal vault prolapse, with a minimum follow-up of 5 years.
METHODS: We prospectively enrolled women with symptomatic vaginal vault prolapse (Pelvic Organ Prolapse Quantification [POP-Q] stage ≥2) who were treated with ICG fixation. Subjective success was defined in the case of Patient Global Impression of Improvement ≤ 2 and an absence of bulging symptoms. Objective success was defined as stage of prolapse < 2 in all compartments. Overall success rate was defined as women without prolapse symptoms, PGI-I ≤ 2, stage of prolapse < 2, and no need for other surgery. All women filled in the Prolapse Quality of Life (P-QOL) questionnaire both at the preoperative visit and at every follow-up visit. Multiple logistic regression was performed to identify factors involved in the risk of recurrent POP.
RESULTS: After a median (range) follow-up of 68.8 (60-92) months the subjective, objective, and overall cure rates were 88.6 % (39 out of 44), 84.1 % (37 out of 44), and 84.1 % (37 out of 44) respectively. Only preoperative stage IV vault descensus independently predicted POP recurrence after iliococcygeus fixation (OR: 8.78 [95 % CI: 1.31-9.42]; p < 0.001).
CONCLUSIONS: Iliococcygeus fixation is a safe and effective surgical technique for the treatment of vaginal vault prolapse with long-lasting effectiveness.
Written by:
Serati M, Braga A, Bogani G, Leone Roberti Maggiore U, Sorice P, Ghezzi F, Salvatore S. Are you the author?
Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
Reference: Int Urogynecol J. 2015 Feb 5. Epub ahead of print.
doi: 10.1007/s00192-015-2629-5
PubMed Abstract
PMID: 25653034