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Objective: To describe our experience with the outcome of surgical procedure -abdominal sacrocolpopexy in the treatment of vaginal vault prolapse occurring after hysterectomy.
Study design: Prospective observational study
Place and Duration: The study was carried out at obstetrics and gynaecology unit ‘A’, Khyber Teaching Hospital, Peshawar. From June 2011 to June 2016.
Methodology: A total of 14 consecutive patients presenting with post-hysterectomy vaginal vault prolapse were included. After preliminary workup, and informed consent abdominal sacrocolpopexy with prolene mesh was carried out in 12 cases while 2 patients refusing this procedure had vaginal repair without mesh.
Results: Mean age of the patients was 52.53 + 7SD and ranged between 45-62 years. Majority 10(71.42%) developed vault prolapse within 5-10 years after hysterectomy. Six (42.85%) had previous surgery in this institution, others were referred cases. It occurred after vaginal hysterectomy in 8(57.15%) and after abdominal hysterectomy in 6(42.85%) patients. All patients had protrusion of vault, urinary symptoms including straining to urinate and incomplete bladder emptying in 9(64.28%), backache 3(21.42%), bowel symptoms in 3, ulceration and discharge 4(28.57%) and dyspareunia in 6(42.85%). Abdominal sacrocolpopexy was performed in 12(85.71%) and conventional vaginal repair in 2(14.28%). Peri-operative and postoperative complications were low, intraoperative bleeding more than 300-400ml in 2, UTI in 3 and recurrent prolapse in 1 patient after vaginal repair. Follow up at 6 weeks, 3 months, 6 months, and 1 year, all patients were satisfied with their surgery in terms of improvement in symptoms and quality of life.
Conclusions: Abdominal sacrocolpopexy is a safe and effective procedure for post-hysterectomy vaginal vault prolapse. It showed a particularly favorable result on prolapse related and functional complaints and a low rate of surgical complications. However larger studies and a longer follow-up is recommended.
Keywords: Vaginal vault prolapse, prolene mesh sacrocolpopexy, complications outcome, vaginal vault suspension.
Talat Naz, Ambreen Sammad, Naheed Akhtar, Madiha Iqbal. (2016) Abdominal Sacro Colpopexy – Surgical Management of Post Hysterectomy Vaginal Vault Prolapse, Journal of the Society of Obstetrics and Gynaecologists of Pakistan , Volume-06, Issue-4.
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