Functional results and quality-of-life after bilateral sacrospinous ligament fixation for genital prolapse.

OBJECTIVES

To evaluate intra- and post-operative complications, anatomical results, quality-of-life and sexuality after bilateral sacrospinous ligament fixation (SSLF).

STUDY DESIGN

Retrospective longitudinal study. Between March 2001 and September 2003, 51 women with stage III or IV genital prolapse underwent bilateral SSLF at the gynecology and obstetrics university department of Tenon Hospital, Paris, France. The population characteristics were as follows: mean age (+/-S.D.) was 64+/-10 years. Mean+/-SD BMI was 25+/-4 and median (range) parity was (0-12). Forty-eight (94%) women were post-menopausal, and one-third had previously undergone hysterectomy. Intra- and post-operative complications and anatomical results were recorded. Quality-of-life questionnaires (IIQ-7 and PISQ-12) and numerical analog scales were administered as well as nine questions on digestive symptoms.

RESULTS

The overall complication rate was 17.3%, with rectal injury in one (1.9%) women. One pararectal hematoma necessitated repeat surgery. Anterior vaginal wall prolapse (Ba=-1) occurred in three women, at 10, 16 and 19 months, but did not necessitate further surgery. The global patient satisfaction rate after bilateral SSLF was 93% (47 women). Digestive symptoms were improved after bilateral SSLF. The mean pre- and post-operative scores on the IIQ-7 and PISQ-12 questionnaires were 41+/-27 and 10+/-18 (p<0.0001), and 62+/-14 and 72+/-11 (p<0.0001), respectively. Posterior perineorrhaphy was associated with significantly altered sexuality.

CONCLUSION

These results support the feasibility of bilateral SSLF: intra- and post-operative complication rates are acceptable, quality-of-life and sexuality are improved, and bowel function is unaffected.