Positive effects of vaginal bilateral hysteropexy with Splentis-tape on prolapse symptoms and quality of life in women with severe pelvic organ prolapse
20 September 2018 (online)
To evaluate the improvement of symptoms and quality of life after uterus-sparing vaginal bilateral hysteropexy with Splentis-tape in women with severe pelvic organ prolapse.
Patients and methods:
Between May 2017 and May 2018 96 patients with uterus prolapse POP-Q > II, aged 41 – 87, were enrolled in this prospective study. All participants responded pelvic floor questionnaires and urogynecological examination preoperatively, 6 and 12 months postoperatively.
Uterus-sparing vaginal bilateral sacrospinous hysteropexy with anterior fascial plication was successfully performed in all cases. Mean operation time was 28 min (13 – 63). No intraoperative complications like bladder lesion, infection, bleeding > 200 ml, eg occurred. Initial mean postoperative pain VAS 0 – 10 was 0.8. Hospital time was 3.4 days, demission at home in all cases with residual urine less 100 ml. After 6 – 12 months there were no erosion or dyspareunia. All patients showed POP-Q ≤ I. 2 patients had pelvic pain VAS 4, 1 patient had hydronephrosis due to kinking ureter through colporrhaphia anterior with insertion of DJ stent. 4 patient developed demasked stress urinary incontinence and were treated with suburethral sling separately.
According to our results, 6 – 12 months after uterus-sparing vaginal bilateral sacrospinous hysteropexy with Splentis-tape patients have significant improvement of prolapse symptoms and general quality of life without severe side effects or complications. Older patients profit from short OR-time. Permanent fixation of vaginal apex/uterus should be focussed, it seems no need for large alloplastic meshes in this situation.