Sacrospinous fixation for vaginal vault prolapse after hysterectomy sec. Miyazaki – longterm results

Česká verzia

Authors: R. Pilka; Milan Kudela ; P. Hejtmánek; P. Dzvinčuk
Authors place of work: Porodnicko-gynekologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D.
Published in the journal: Ceska Gynekol 2013; 78(1): 27-31

Summary

Objective:
To assess intra- and postoperative complications and to look for long term follow-up results in women with sacrospinous ligament fixation for vaginal vault prolapse sec. Miyazaki.

Design:
Retrospective study.

Setting:
Department of Obstetrics and Gynecology, University Hospital, Olomouc.

Methods:
Between January 2002 and December 2011,112 women (mean age 66.8, range 44 to 88 years) underwent vaginal unilateral sacrospinous ligament fixation sec. Miyazaki; 101 patients had prior hysterectomy. In 11 patients concomitant hysterectomy and sacrospinous ligament fixation was performed.

Results:
All 112 patients were analysed for intra and postoperative complications. Urinary tract infection (n=6; 5.3%), hematoma (n=6; 5.3%), temporary urinary retention (n=3; 2.7%), and temporary irritation of the static nerve (n=2; 1.6%), occurred in the postoperative phase. Long term data (range from 1 month to 8 years, mean 22 months) exist for 59 patients. 56 were completely cured without any signs of urinary inkontinence and prolapse. At follow-up 3 patients (5.1%) showed recurrent vaginal vault prolapse. Recurrent cystoceles and rectoceles were found in 10 (16.9%) and one (1.6%) cases respectively. Three patiens with complete recurrence of vaginal vault prolapse successfully underwent repeated sacrospinous ligament fixation sec. Miyazaki (2 cases) or polypropylene mesh insertion (1 case).

Conclusion:
Sacrospinous ligament fixation sec. Miyazaki is an effective and safe procedure with a low recurrence and complication rate.

Keywords:
acrospinous ligament fixation – vaginal vault prolapse – complications – Miyazaki

Zdroje

1. Albrich, W. Vaginale sakrospinale fixation – anatomische grundlagen, chirurgische technik und ergebnisse. Gynaekologie, 1996, 29, p. 665–670.

2. Amreich, J. Etiology and surgery of vaginal stump prolapses. Wien Klin Wochenschr, 1951, 63(5), p. 74–77.

3. Arthur, HG., Savage, D. Uterine prolapse and prolapse of vaginal vault treated by sacral hysteropexy. J Obstet gynecol Br Emp, 1957, 64, p. 355–360.

4. Backer, MH., Jr. Success with sacrospinous suspension of the prolapsed vaginal vault. Surg Gynecol Obstet, 1992, 175(5), p. 419–420.

5. Carey, MP., Slack, MC. Vaginal vault prolapse. Br J Hosp Med, 1994, 51(8), p. 417–420.

6. Cruikshank, SH., Cox, DW. Sacrospinous ligament fixation at the time of transvaginal hysterectomy. Am J Obstet Gynecol, 1990, 162(6), p. 1611–1615; discussion 1615–1619.

7. Dellas, A., Almendral, AC. [Surgical treatment of vaginal prolapse after hysterectomy. Geburtshilfe Frauenheilkd, 1995, 55(5), p. 244–246.

8. Halaska, M. Fixation of the prolapsed vagina to the sacrospinous ligament after hysterectomy – the Amreich II-Richter vaginal fixation operation. Ces Gynek, 1997, 62(6), p. 323–329.

9. Halaska, M. Descensus orgánů malé pánve. In: Houdek, L., ed. Urogynekologie. Praha: Galén, 2004, p. 136–147.

10. Holley, RL., Varner, RE., Gleason, BP., et al. Recurrent pelvic support defects after sacrospinous ligament fixation for vaginal vault prolapse. J Am Coll Surg, 1995, 180(4), p. 444–448.

11. Chapin, DS. Teaching sacrospinous colpopexy. Am J Obstet Gynecol 1997, 177(6), p. 1330–1336.

12. Imparato, E., Aspesi, G., Rovetta, E., et al. Surgical management and prevention of vaginal vault prolapse. Surg Gynecol Obstet, 1992, 175(3), p. 233–237.

13. Kudela, M., Ondrova, D., Pilka, R., et al. Sacrospinous fixation of the prolapsed vagina after the Miyazaki hysterectomy procedure. Ces Gynek, 2004, 69(6), p. 493–497.

14. Lane, FE. Repair of post-hysterectomy vaginal vault prolapse. Obstet Gynecol, 1962, 20, p. 72–77.

15. Lantzsch, T., Goepel, C., Wolters, M., et al. Sacrospinous ligament fixation for vaginal vault prolapse. Arch Gynecol Obstet, 2001, 265(1), p. 21–25.

16. Miller, NF. A new method of correcting complete inversion of the vagina with of without complete prolapse, two cases. Surg Gynecol Obstet, 1927, 44, p. 550–554.

17. Miyazaki, FS. Miya Hook ligature carrier for sacrospinous ligament suspension. Obstet Gynecol, 1987, 70(2), p. 286–288.

18. Monk, BJ., Ramp, H., Montz, FJ., Febherz, TB. Sacrospinous ligament fixation for vaginal vault prolapse. Complications and results. J Gynecol Surg, 1991(7), p. 87–92.

19. Morley, GW., DeLancey, JO. Sacrospinous ligament fixation for eversion of the vagina. Am J Obstet Gynecol, 1988, 158(4), p. 872–881.

20. Nichols, DH. Sacrospinous fixation for massive eversion of the vagina. Am J Obstet Gynecol, 1982, 142(7), p. 901–904.

21. Paraiso, MF., Ballard, LA., Walters, MD., et al. Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol, 1996, 175(6), p. 1423–1430; discussion 1430–1431.

22. Pasley, WW. Sacrospinous suspension: a local practitioner‘s experience. Am J Obstet Gynecol, 1995, 173(2), p. 440–445; discussion 445–448.

23. Penalver, M., Mekki, Y., Lafferty, H., et al. Should sacrospinous ligament fixation for the management of pelvic support defects be part of a residency program procedure? The University of Miami experience. Am J Obstet Gynecol, 1998, 178(2), p. 326–329.

24. Pilka, R. Robotická chirurgie v gynekologii. Endoskopie, 2011, 20(2), p. 46–50.

25. Randall, CL., Nichols, DH. Surgical treatment of vaginal inversion. Obstet Gynecol 1971, 38(3), p. 327–332.

26. Richter, K. Prevention and therapy of vaginal prolapse following hysterectomy. Zentralbl Gynakol, 1963, 85, p. 1042–1043.

27. Richter, K. The surgical treatment of the prolapsed vaginal fundus after uterine extirpation. A contribution on Amreich‘s the sacrotuberal vaginal fixation. Geburtshilfe Frauenheilkd, 1967, 27(10), p. 941–954.

28. Richter, K., Albrich, W. Long-term results following fixation of the vagina on the sacrospinal ligament by the vaginal route (vaginaefixatio sacrospinalis vaginalis). Am J Obstet Gynecol, 1981, 141(7), p. 811–816.

29. Sederl, J. [Surgery in prolapse of a blind-end vagina]. Geburtshilfe Frauenheilkd, 1958, 18(6), p. 824–828.

30. Veronikis, DK., Nichols, DH. Ligature carrier specifically designed for transvaginal sacrospinous colpopexy. Obstet Gynecol, 1997, 89(3), p. 478–481.

31. Zweifel, P. Vorlesungen über klinische Gynäkologie. Berlin: Hirschwald, 1892.