Laparoscopic Sacrocolpopexy as a Treatment of Choice in Patients with Vaginal Vault Prolapse

Abstract

Introduction: The vaginal vault Prolapse is a complication that affects 0.2 and 2 % of patients who have undergone total hysterectomy, which affects their quality of life and requires surgery to correct it.
Objective: To describe the results of laparoscopic sacrocolpopexy in the treatment of post-hysterectomy vaginal vault prolapse.
Methods: An observational, descriptive and cross-sectional study was carried out in a consecutive series of 41 patients diagnosed with prolapse of the vaginal vault as a complication of a previous hysterectomy. They were treated for surgical correction by laparoscopy at the National Center for Minimum Access Surgery in Havana, Cuba, from August 1, 2008 until April 30, 2016.
Results: The mean age of the patients who underwent surgery was 61,1 ± 11,8 years. The most frequent personal health antecedent was hypertension (58,8 %). The most common previous surgery was abdominal hysterectomy by laparotomy (51.2 %). The average surgical time was 134.3 minutes; the range was 90 - 240 minutes. A bladder lesion (2.4 %) occurred as the only intraoperative complication and there was no indication for surgical conversion to the conventional laparotomy. Postoperative complications occurred in four patients (9.7 %), urinary incontinence in two of them, a rejection of the mesh and a case of osteomyelitis.
Conclusions: Laparoscopic sacrocolpopexy is a safe and feasible therapeutic alternative in the treatment of posthysterectomy vaginal vault prolapse.