Publication:

Case series of abdominal sacral colpopexy

Background Abdominal sacral colpopexy is a transabdominal procedure that suspends vaginal vault to the sacrum using natural or synthetic graft material. We can perform this procedure in patients who have Post hysterectomy vault prolapse. Primary indication of this procedure is to resuspend a prolapsed vaginal apex. Secondary indications include repair of the cystocele, posterior vaginal wall and apical segment descent. The goal of this study was to assess the complications of repair of post hysterectomy vaginal vault proplase with polypropylene mesh.

Methods This study was conducted on 8 patients scheduled to undergo abdominal sacral colpopexy in SVBP Hospital associated to LLRM Medical College, Meerut, UP, India from March 2011 to March 2016 who had vault prolapse after hysterectomy. When patients complained of something coming out of vagina, pelvic examination was done by consultant in OPD during valsalva manoeuvre and per speculum examination. Pelvic organ prolapse quantification classification was used to classify prolapse. Two consultants performed all operations based on a standardized surgical technique.

Results In our study, all patients were followed for up to one year (at 3 months, 6 months, one year) after surgery for following observations- recurrence of prolapse, mesh erosion, dyspareunia, lower abdominal pain, constipation. None of the patient had above complaints in the follow up period.

Conclusions Abdominal sacral colpopexy with polypropylene mesh is a safe, effective treatment in patients having post hysterectomy vaginal vault proplase. When done by experienced gynecologist, major post-operative complications seem to be very few in patients having normal BMI & no major systemic illnesses.