Abdominal fixation of the vagina - Surgical technique and outcome

Objective: Abdominal fixation of the vagina by transplanting the aponeurosi s of the external oblique abdominal muscle is a simple, low-risk procedure for sexually active women with posthysterectomy prolapse of the vaginal vau lt or marked uterine prolapse at the time of abdominal hysterectomy. If loc al tissue is poor, the aponeurosis can be reinforced with a 10-mm wide stri p of dioxanone (PDS(R)). The purpose of this study was to evaluate the subj ective and objective results of this procedure. Methods: 73 women were interviewed and examined an average of 26 months aft er surgery. Patient satisfaction was measured with regard to urinary contin ence, sensation, sexual activity, and quality of life. Vaginal descensus, c ystocele and rectocele were classified as grade 1 to 3.77% of the patients had grade 2 or 3 vaginal prolapse preoperatively. Results: Postoperatively 95% of the patients had no vaginal descensus and n one of the remaining patients had grade 3 prolapse. More than 75% of the wo men considered themselves better or far better than before. Two patients fe lt worse than before surgery. Conclusion: The long-term results of this procedure are satisfactory. PDS w as well tolerated.