SACROSPINOUS VAULT SUSPENSION AND ABDOMINAL COLPOSACROPEXY - SUCCESS RATES AND COMPLICATIONS

OBJECTIVE: Our purpose was to compare success rates and complications of sacrospinous vault suspension and abdominal colposacropexy. STUDY D ESIGN: A case series is presented of 130 attempted sacrospinous vault suspensions with the Miya hook and 80 cases of abdominal colposacropex y, done in conjunction with other procedures. Patients were assessed 6 weeks and 6 and 12 months after surgery and yearly thereafter. RESULT S: Sacrospinous vault suspension was completed in 125 women (5 abandon ed because of technical difficulty). Abdominal colposacropexy was comp leted in all 80 woman. There was only one intraoperative complication- hemorrhage from the presacral veins during abdominal colposacroplexy. The incidence of postoperative febrile morbidity was 10% after sacrosp inous vault suspension and 6% after abdominal colposacropexy. Follow-u p ranged from 6 months to 5 years. The incidence of recurrent vault pr olapse was 2.4% with sacrospinous vault suspension and 1.3% with abdom inal colposacropexy. Demonstrable stress urinary incontinence occurred in one woman after abdominal colposacropexy and in none after sacrosp inous vault suspension. CONCLUSION: Sacrospinous vault suspension and abdominal colposacropexy are associated with a tow incidence of intrao perative and postoperative complications and recurrent vault prolapse. Latent stress urinary incontinence may be unmasked, particularly with abdominal colposacropexy, and preoperative urodynamic evaluation is t herefore recommended.