BILATERAL ATTACHMENT OF THE VAGINAL CUFF TO ILIOCOCCYGEUS FASCIA - ANEFFECTIVE METHOD OF CUFF SUSPENSION

OBJECTIVE: The objective of this study was to determine the anatomic s uccess, defined as no persistent or recurrent support defects, of susp ension of the vaginal cuff to iliococcygeus fascia. STUDY DESIGN: Fort y-two women treated by suspension of the vaginal cuff to iliococcygeus fascia and repair of coexisting pelvic support defects between March 19, 1987, and June 11, 1992, had site-specific analysis of pelvic supp ort performed preoperatively and at consecutive postoperative visits. The findings at the 6-week postoperative visit and subsequent visits w ere compared for support of the vaginal cuff and additonally for the u rethra, bladder, cul-de-sac, and rectum. RESULTS: Two patients (5%) ha ve had recurrence of their cuff prolapse during follow-up, one of whom required further surgery. She also had recurrence of an inguinal hern ia that had been repaired at the original surgery. The other patient w ho had had five previous pelvic procedures developed asymptomatic prol apse of the cuff halfway to the hymen. Six additional patients have ha d loss ot support at other sites in the follow-up period, one of whom had repeat surgery.CONCLUSION: Ninety-five percent of women experience d no persistence or recurrence of cuff prolapse 6 weeks to 5 years aft er the procedure.