Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: A prospective randomized study

• Published in: American journal of obstetrics and gynecology 2004, Vol.190 (1), p.20-26
• Main Authors: Maher, Christopher F, Qatawneh, Aymen M, Dwyer, Peter L, Carey, Marcus P, Cornish, Ann, Schluter, Philip J
• Format: Article
• Language: English
• Subjects: Abdomen; Activities of Daily Living; Biological and medical sciences; Dyspareunia - complications; Dyspareunia - etiology; Female; Gynecologic Surgical Procedures - adverse effects; Gynecologic Surgical Procedures - economics; Gynecologic Surgical Procedures - methods; Gynecology. Andrology. Obstetrics; Health Care Costs; Humans; Medical sciences; Quality of Life; Remission Induction; Sacral colpopexy; Sacrococcygeal Region; Sacrospinous colpopexy; Sexual Behavior; Surgical Mesh; Suture Techniques; Time Factors; Treatment Outcome; Uterine Prolapse - complications; Uterine Prolapse - surgery; Vagina; Vault prolapse
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2003.08.031

The purpose of this study was to compare the abdominal sacral colpopexy and vaginal sacrospinous colpopexy in the treatment of vaginal vault prolapse. Ninety-five women with vaginal vault prolapse were allocated randomly to sacral colpopexy (47 women) or sacrospinous colpopexy (48 women). Primary outcome measurements include subjective, objective, and patient-determined success rates. Secondary outcomes include the impact on bowel, bladder, and sexual function, cost, and quality of life. Two years after the operation (range, 6-60 months), the subjective success rate was 94% in the abdominal and 91% in the vaginal group ( P = .19). The objective success rate was 76% in the abdominal group and 69% in the vaginal group ( P = .48). The abdominal approach was associated with a longer operating time, a slower return to activities of daily living, and a greater cost than the sacrospinous colpopexy ( P