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Perioperative course and medium‐term outcome of the transobturator and infracoccygeal hammock for posthysterectomy vaginal vault prolapse
Author(s) -
Sergent Fabrice,
Zanati Joël,
Bisson Violène,
Desilles Nicolas,
Resch Benoît,
Marpeau Loïc
Publication year - 2010
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2009.11.020
Subject(s) - medicine , vaginal vault prolapse , vaginal vault , vault (architecture) , surgery , perioperative , term (time) , vagina , physics , structural engineering , quantum mechanics , engineering
Abstract Objective To describe the perioperative course and medium‐term anatomic and functional outcomes of the transobturator–infracoccygeal hammock for posthysterectomy vaginal vault prolapse repair. Methods A prospective consecutive series of 52 women with a stage 2 vaginal vault prolapse or higher that occurred after total hysterectomy who underwent surgery between 2003 and 2007. Principal outcome measures were anatomic cure (stage 1 or lower) and impact on quality of life measured using the pelvic floor distress inventory (PFDI) and pelvic floor impact self‐reported questionnaire (PFIQ). Anatomical results were analyzed using χ 2 and Fisher exact tests, and PFDI and PFIQ scores were analyzed using the Wilcoxon test. Results With a median follow‐up of 36 months, the anatomic cure rate was 96%. Significant improvements were noted in POPQ‐S scores after surgery ( P < 0.05). Stress urinary incontinence was cured in 73% of patients and improved in 15% of patients. The PFDI and PFIQ scores were improved ( P < 0.05). One mesh extrusion was observed. The rates of mesh contraction and new cases of dyspareunia were 31% and 13%, respectively. Conclusion The transvaginal mesh hammock represents a useful treatment for recurrent and major vaginal vault prolapse, and has few complications.