Outcomes and recurrence rates of four surgical techniques for treating vaginal vault prolapse

Abstract

Aims: This study aimed to compare the surgical outcomes of four distinct techniques for vaginal vault prolapse (VVP) after hysterectomy to identify the optimal approach. Methods: This retrospective study was conducted using the data of patients who underwent VVP between 2010 and 2022 and had a history of hysterectomy. The surgical techniques evaluated were laparotomic sacrocolpopexy (LPSC), laparoscopic sacrocolpopexy (LSSC), sacrospinous ligamentopexy (SSLP), and laparoscopic lateral suspension (LLS). The study outcomes were the surgical duration, VVP recurrence, and adverse outcomes. Results: The study included 77 women (age, mean±standard deviation: 58.96±9.96 years). LPSC, LSSC, SSLP, and LLS were detected in 27 (35%), 10 (13%), 31 (40.3%), and 9 (11.7%) cases, respectively. The duration of the surgery was significantly different among the groups (SSLP group: 115.96±51.29 min, LPSC group: 143.51±31.46 min, LLS group: 168.33±53.20 min, and LSSC group: 197.50±62.46 min, p=0.012). The recurrence rate of VVP was 11.11% in the LPSC group, 12.9% in the SSLP group, 11.11% in the LLS group, and 0.0% in the LSSC group (p=0.838). The rates of adverse outcomes in the early and late periods did not differ across the four groups, with p values of 0.274 and 0.556 (LPSC group: 18.52% and 18.52%, LSSC group: 20.0% and 20.0%, SSLP group: 6.46% and 22.58%, and LLS group: 0.0% and 22.22%). Conclusions: Surgical techniques for VVP, including LPSC, LSSC, SSLP, and LLS, showed comparable outcomes and recurrence rates, except for the duration of surgery, which was the lowest in the SSLP group and longest in the LSSC group.

Keywords

• laparoscopic lateral suspension
• laparotomic sacrocolpopexy
• laparoscopic sacrocolpopexy
• sacrospinous ligamentopexy