Comparison Between Unilateral and Bilateral Sacrospinous Ligament Fixation for Management of Vault Prolapse

Background: Hysteropexy is an effective procedure for vault prolapse as abdominal sacrocolpopexy but easier and simple. Right sacrospinous fixation has the same results of bilateral fixation. Aim of the work: To evaluate the value and safety of unilateral or bilateral sacrospinous fixation [SSF]. Patients and methods: A prospective observational study was conducted in the Department of Obstetrics and Gynecology, Al-Azhar University, Damietta over a period of two years [July 2017 to June 2019]. A total of 32 patients posted for 16 cases unilateral sacrospinous ligament fixation to vault and 16 cases for bilateral fixation were enrolled after informed consent. Results were recorded under headings of procedure time [min], blood loss [ml], major intro-operative complications and post-operative complications, postoperative pain and duration of hospital stay. Results: The result of unilateral transvaginal sacrospinous ligament fixation technique, as part of the vaginal repair procedure for massive uterovaginal [Pelvic Organ Prolapse stage III and stage IV and vault prolapse] was evaluated as better than bilateral approach with the same efficacy, less time consuming, less blood loss and low post-operative pain. Conclusion: Unilateral transvaginal sacrospinous ligament fixation revealed a significant reduction in intraoperative blood loss, procedure time, immediate post-operative pain, and mean length of hospital stay.