Abstract
Objective: To evaluate sacro-spinous ligament fixation (SLF) peri-operative complications. Study design: Monocentric, retrospective study. Department of Gynecology, SIHCUS-CMCO, University
Hospital, Strasbourg, France. Between January 1990 and December 2000, 195 women, mean
age 63.2 years old (40–90), underwent a vaginal SLF. Ninety point eight percent of
women were post-menopaused and 27.9% of these had a hormonal substitution. About 24%
of patients had prior hysterectomy, 20% vaginal prolapse repair and 22% urinary stress
incontinence repair. SLF was performed in 1.5% of cases without any other procedures
and it was combined with the following: rectocele and elytrocele repair in 89.2%,
hysterectomy in 72.3%, cystocele repair in 52.8% and stress incontinence repair in
15.3% of cases. In 107 cases, the SLF attachment was placed under digital control
and in 88 cases under visual control. Results: The mean hospitalisation stay was of 8.5 ± 2.6 days (4–26). About 41% of women presented
a complication. Major complications were represented by 3.6% of bladder injury, 0.5%
of uretero-vaginal fistula, 0.5% of vascular injuries, 0.5% of thromboembolic events.
In 38% of cases patients had minor complications: urinary tract infections (29%),
temporary urinary retention (5.6%), local complications (4.5%), and other complications
(3%). The only specific SLF complication in this data was a vascular injury and in
this case the SLF was performed under digital control. Conclusions: The global peri-operative complication frequency of SLF is high. It is mainly represented
by non-specific complications, secondary to the combined procedures and not to the
SLF itself. The specific complications due to SLF, all of which are major ones, can
be avoided or diagnosed earlier, by using the visual approach technique.
Keywords
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Article info
Publication history
Accepted:
December 5,
2003
Received in revised form:
October 1,
2003
Received:
March 3,
2003
Identification
Copyright
© 2003 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
