ABSTRACT

Objective:

The aim of this study was to compare the efficacy, outcomes and complications of sacrospinous ligament fixation (SSLF) with native tissue repair and infracoccygeal sacropexy with transvaginal mesh (TVM) in the management of vaginal vault prolapse.

Material and Methods:

We recruited 63 women with stage 3, or greater prolapse, according to the pelvic organ prolapse quantification (POPQ) system, requiring surgical correction. They were randomized in two groups: SSLF (n = 31) and TVM (n = 32). The primary outcome was the absence of POP-Q stage ≥3 prolapse at 24 months, and secondary outcomes were perioperative events, complications and reoperations. The participants were followed for the next 2 years, with scheduled evaluation.

Results:

Clinical and demographic data did not differ significantly between the two treatment groups. Success in the TVM group was 84.3% (27/32) compared to 61% (19/31) in the SSLF group. Although there was not statistically significant differences between the groups, the prolapse recurrence trend was lower in the TVM group (RR 0.73). Recurrent prolapse occurred most frequently in the vaginal anterior wall (14.3%). The mesh exposure rate was 9.3%. Neither serious adverse events nor deaths occurred in either group.

Conclusion:

Our results showed that vaginal repair with mesh surgery was more successful in terms of reducing recurrent prolapse than the traditional sacrospinous colpopexy, 24 months after surgery.