Sacrospinous ligament fixation for apical prolapse repair compared to other vaginal procedures

Abstract

The vaginal procedures for uterine prolapse and/or vaginal vault prolapse are based on the attachment of the vaginal apex at the sacrospinous ligament (SL), the uterosacral ligaments (USL) or the iliococcygeus fascia. The fixation at the sacrospinous ligament (SSL) known as sacrospinous ligament fixation (SSLF) is the most studied and performed method for apical prolapse repair. Generally, it is preferred for cases of vaginal vault prolapse post-hysterectomy compared with the suspension at the uterosacral ligament (USLS) that it is usually performed at the time of uterus removal. Due to its associated high rate of recurrence, especially prolapse of the anterior vaginal wall, SSLS has been progressively abandoned in the favor of other modern vaginal procedures such as the Saba Nahedd technique. However, the frequently reported esh associated complications, there are still logical reasons to continue the performance and development of the SSLF technique. In order to assess the current frequency of application and effectiveness of SSLF we have made a review on the recently published literature on the SSLF technique focusing on the rate of success and recurrence, the peri-and postoperative complications, its impact on the daily activities and sexual function. We have selected systhematic reviews, follow-up and retrospective studies as well as metanalyses which have been published in the last 10 years in the german or english language. The aim of this article is to describe the SSLF technique and its advantages in the treatment of sever uterovaginal or vaginal vault prolapse.

Keywords

• sacrospinous ligament fixation
• uterine prolapse
• uterosacral ligaments