Sacrospinous vault suspension and abdominal colposacropexy: success rates and complications.

OBJECTIVE: Our purpose was to compare success rates and complications of sacrospinous vault suspension and abdominal colposacropexy.

STUDY DESIGN: A case series is presented of 130 attempted sacrospinous vault suspensions with the Miya hook and 80 cases of abdominal colposacropexy, done in conjunction with other procedures. Patients were assessed 6 weeks and 6 and 12 months after surgery and yearly thereafter.

RESULTS: Sacrospinous vault suspension was completed in 125 women (5 abandoned because of technical difficulty). Abdominal colposacropexy was completed in all 80 women. There was only one intraoperative complication-hemorrhage from the presacral veins during abdominal colposacroplexy. The incidence of postoperative febrile morbidity was 10% after sacrospinous vault suspension and 6% after abdominal colposacropexy. Follow-up ranged from 6 months to 5 years. The incidence of recurrent vault prolapse was 2.4% with sacrospinous vault suspension and 1.3% with abdominal colposacropexy. Demonstrable stress urinary incontinence occurred in one woman after abdominal colposacropexy and in none after sacrospinous vault suspension.

CONCLUSION: Sacrospinous vault suspension and abdominal colposacropexy are associated with a low incidence of intraoperative and postoperative complications and recurrent vault prolapse. Latent stress urinary incontinence may be unmasked, particularly with abdominal colposacropexy, and preoperative urodynamic evaluation is therefore recommended.