Surgical outcomes of sacrospinous ligament fixation at the time of vaginal hysterectomy for vaginal vault prolapse prevention: 10 years review

AIMS: To study the non-recurrent prolapse rate after vaginal hysterectomy colpoperineorrhaphy and sacrospinous ligament fixation (SSLF) with or without anterior colporrhaphy, with or without posterior colpoperineorrhaphy. MATERIALS AND METHODS: A retrospective cohort study was carried out at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, during January 1, 2012-December 31, 2021. The inclusion criteria were Thai women diagnosed with uterovaginal prolapse and undergone vaginal hysterectomy, with or without anterior colporrhaphy, with or without posterior colpoperineorrhaphy, with SSLF and had the complete pelvic organ prolapse quantification (POP-Q) information at the 12 months follow up. The recurrent case was defined as any compartment prolapse ≥ stage II by POP-Q classification at 1, 3, 6, 12 months follow up. RESULTS: Of 71 cases included, 20 cases had recurrent prolapse at 12 months. The incidences of non-recurrent prolapse rate at 1, 3, 6, and 12 months were 70/71 (98.59%), 65/70 (92.86%), 58/65 (89.23%), and 51/58 (87.93%). The overall PHVP prevalence at 12 months was 2/71 (2.81%). The anterior compartment prolapse were 18/71 (25.35%) at 12 months. The most common postoperative complications were the urinary tract infection (4.23%). There were one case of nerve entrapment and one case of stitches exposure that required stitches removal. CONCLUSION: SSLF at the time of vaginal hysterectomy is safe and effective in post hysterectomy vaginal vault prolapse prevention. But there are high recurrence rate of anterior compartment prolapse at 12 months. Preoperative counseling and long-term follow up after SSLF is advocated.