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Sexual function after sacrospinous fixation for vaginal vault prolapse: bad or mad?

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Abstract

Background

The main indication for sacrospinous ligament suspension is to correct either total procidentia, a posthysterectomy vaginal vault prolapse with an associated weak cardinal uterosacral ligament complex, or a posthysterectomy enterocele. This study aimed to evaluate sexual function and anatomic outcome for patients after sacrospinous ligament suspension.

Methods

For this study, 52 patients who had undergone sacrospinous ligament fixation during the preceding 5 years were asked to complete the Female Sexual Function Index (FSFI) questionnaire. The patients were vaginally examined using the ICS POP score, and the results were compared with their preoperative status. For statistical analysis, GraphPad for Windows, version 4.0, was used.

Results

The 52 patients were examined during a follow-up period of 38 months. No major intraoperative complications were noted. Recurrence of symptomatic apical descent was noted in 6% of the patients and de novo prolapse in 13.5%. Only one patient was symptomatic. Three patients experienced de novo dyspareunia, which resolved in two cases after stitch removal. Sexual function was good, rating higher than three points for each of the domains including satisfaction, lubrication, desire, orgasm, and pain.

Conclusion

Sacrospinous ligament fixation still is a valuable option for the treatment of vaginal vault prolapse. Sexual function is satisfactory, with few cases of de novo dyspareunia.

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References

  1. Amreich Aetiologie und Operation des Scheidenstumpfprolpases (1951) Wien Klin Wochenschr 63:74–77

    Google Scholar 

  2. Richter K (1968) Die chirurgische Anatomie der Vaginaefixation sacrospinalis: Ein Beitrag zur operativen Behandlung des Scheidenblindsackprolapses. Geburth Frauenheilk 28:321–327

    CAS  Google Scholar 

  3. Carey MP, Slack MC (1994) Transvaginal sacrospinous colpopexy for vault and marked uterovaginal prolapse. Br J Obstet Gynecol 101:536–540

    CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  5. Cruikshank SH, Cox DW (1990) Sacrospinous ligament fixation at the time of transvaginal hysterectomy. Am J Obstet Gynecol 162:1611–1619

    PubMed  CAS  Google Scholar 

  6. Cruikshank SH (1991) Sacrospinous fixation: should this be performed at the time of vaginal hysterectomy? Am J Obstet Gynecol 164:1072–1076

    PubMed  CAS  Google Scholar 

  7. Hefni M, El-Thouky T, Bhaumik J, Katsimanis E (2003) Sacrospinous cervicocolpopexy with uterine conservation for uterovaginal prolapse in elderly women: an evolving concept. Am J Obstet Gynecol 188:645–650

    Article  PubMed  CAS  Google Scholar 

  8. Kovac RC, Cruikshank SH (1993) Successful pregnancies and vaginal deliveries after sacrospinous uterosacral fixation in five of nineteen patients. Am J Obstet Gynecol 168:1778–1790

    PubMed  CAS  Google Scholar 

  9. Kettel ML, Herbertson RM (1989) An anatomic evaluation of the sacrospinous ligament colpopexy. Surg Gynecol Obstet 168:318–322

    PubMed  CAS  Google Scholar 

  10. Peters WA, Christenson ML (1995) Fixation of the vaginal apex of the coccygeal fascia during repair of vaginal vault eversion with enterocele. Am J Obstet Gynecol 172:1894–1902

    Article  PubMed  Google Scholar 

  11. Paraiso MF, Ballard LA, Wallace MD (1996) Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol 175:1423–1431

    Article  PubMed  CAS  Google Scholar 

  12. Holley RJ, Varner RE, Gleason BP (1995) Recurrent pelvic support defects after sacrospinous ligament fixation for vaginal vault prolapse. J Am Coll Surg 180:444–448

    PubMed  CAS  Google Scholar 

  13. Suckling J, Lethaby A, Kennedy R (2006) Local oestrogen for vaginal atrophy in postmenopausal women (review). Cochrane Database Syst Rev 18(4):CD001500

    Google Scholar 

  14. Sze EH, Karram MM (1997) Transvaginal repair of vault prolapse: a review. Obstet Gynecol 89:466–475

    Article  PubMed  CAS  Google Scholar 

  15. Barksdale PA, Gasser RF, Gauthier CM, Elkins TE, Wall LL (1997) Intraligamentous nerves as a potential source of pain after sacrospinous ligament fixation of the vaginal apex. Int J Pelvic floor Dysfunct 8:121–125

    Article  CAS  Google Scholar 

  16. Richter K, Albrich W (1981) Long-term results following fixation of the vagina on the sacrospinous ligament by the vaginal route. Am J Obstet Gynecol 141:811–816

    PubMed  CAS  Google Scholar 

  17. Holley RL, Varner RE, Gleason BP, Apffel LA, Scott S (1996) Sexual function after sacrospinous ligament fixation for vaginal vault prolapse. J Reprod Med 41:355–358

    PubMed  CAS  Google Scholar 

  18. Estrade JP, Agostini A, Roger V, Dallay D, Blanc B, Cravello L (2004) Sacrospinous colpopexy complications. Gynecol Obstet Fertil 32:850–854

    PubMed  Google Scholar 

  19. Farrell SA, Scotti TA, Ostergard D (1991) Massive evisceration: a complication following sacrospinous vaginal vault fixation. Obstet Gynecol 78:560–562

    PubMed  CAS  Google Scholar 

  20. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D’Agostino R Jr (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208

    Article  PubMed  CAS  Google Scholar 

  21. Robinson JG, Molzahn AE (2007) Sexuality and quality of life. J Gerontol Nurs 33:19–27

    PubMed  Google Scholar 

  22. Hines TM (2001) The G-Spot: a modern gynaecologic myth. Am J Obstet Gynecol 185:359–362

    Article  PubMed  CAS  Google Scholar 

  23. Smith LJ, Mulhall JP, Deveci S, Monaghan N, Reid MC (2007) Sex after seventy: a pilot study of sexual function in older persons. J Sex Med 4:1247–1253

    Article  PubMed  Google Scholar 

  24. Bancroft JHJ (2007) Sex and aging. New Engl J Med 357:820–822

    Article  PubMed  CAS  Google Scholar 

  25. Scherlitz L, Dwyer P, Rosamilia A, Murray C, Thomas E, Taylor N, Hiscock R, Lim Y, Achtari C, De Souza A (2007) A prospective randomised controlled study comparing vaginal prolapse repair with and without tension free vaginal tape (TVT) in women with severe pelvic organ prolapse and occult stress incontinence. ICS annual meeting Rotterdam, Abstract 114

  26. David-Montefiore E, Barranger E, Dubernard G, Nizard V, Antoine JM, Darai E (2007) Functional results and quality of life after bilateral sacrospinous ligament fixation for genital prolapse. Eur J Obstet Gynecol Reprod Biol 132:209–211

    Article  PubMed  Google Scholar 

  27. Handa VL, Zyczinski HM, Brubaker L, Nygaard I, Janz NK, Richter HE, Brown MB, Weber AM (2007) Pelvic disorders network: sexual function before and after sacrocolpopexy for pelvic organ prolapse. Am J Obstet Gynecol 197:629.e1-6

    Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Inselspital, Bern University Hospital and University of Bern, Effingerstrasse 102, CH-3010, Bern, Switzerland

    Marc Baumann, Claudia Salvisberg, Michel Mueller & Annette Kuhn

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  1. Marc Baumann
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  2. Claudia Salvisberg
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  3. Michel Mueller
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  4. Annette Kuhn
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Correspondence to Annette Kuhn.

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Baumann, M., Salvisberg, C., Mueller, M. et al. Sexual function after sacrospinous fixation for vaginal vault prolapse: bad or mad?. Surg Endosc 23, 1013–1017 (2009). https://doi.org/10.1007/s00464-008-0108-5

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  • DOI: https://doi.org/10.1007/s00464-008-0108-5

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