Sacrospinous ligament fixation surgical outcoms after hysterectomy for apical support in a local population at a tertiary hospital - a retrospective descriptive study
Date
2024-03
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Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Introduction: Sacrospinous ligament fixation (SSLF) is a surgical procedure designed to restore support of the uterus or vaginal vault, often performed post hysterectomy. It involves attaching upper most lateral aspect of the vaginal vault to the sacrospinous ligament. Complications can include 5-10% failure rate, <1% risk of bleeding requiring blood transfusion, <1% risk of deep venous thrombosis and 1-5% risk of urinary tract infections, as well as potential dyspareunia. However, there is limited research on SSLF success and failure rate in the local population.
Aims and Objectives: This study aimed to evaluate the surgical outcomes of sacrospinous ligament fixation for level 1 and apical support of the vagina in pelvic organ prolapse (POP) repair.
Methods: A Retrospective chart review was conducted on 86 women with pelvic organ prolapse who underwent clinical examination and sacrospinous ligament fixation after hysterectomy at Tygerberg Hospital between January 2014 and December 2019. POP was clinically evaluated and graded using POP-Q system. Preoperative and postoperative clinical assessment included the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Retrospective data analysis extended up to 3 years post-operation. Microsoft™ Excel software was used for data entry, cleaning and analysis.
Results: Patient ages ranged from 38 to 79 years with a mean of 59 years. Eighty percent of patients were overweight or obese, and 75% had parity between 2 and 5. Symptomatic POP was present in 97% of cases, with grade 3 and 4 POP accounting for 93% of the diagnoses. Initial surgery resulted in no recurrence in 88% of patients. Site specification for SSLF was lacking in 23.2% of cases, without reasons provided for the omission. The PGI-I combined
with post operation ICIQ-SF revealed that ninety-six percent of patients reported 100% satisfaction with treatment while clinical evaluation showed that anatomical success was achieved in 87.2% of the cases. Complications related to the surgery were reported by only 3.6% of patients. Regarding incontinence, 49% experienced improvement, 9% reported no change in symptoms ,1% had new symptoms, and 40% remained incontinent before and after the operation.
Conclusion: SSLF demonstrated excellent anatomical support and high patient satisfaction rates.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (MMed) -- Stellenbosch University, 2024.