[Vaginal vault suspension by posterior transobturator sling].

OBJECTIVE

A study on the feasibility and safety of a new surgical procedure of vaginal vault suspension using a polypropylene mesh placed in the uterovaginal septum by a posterior transobturator approach.

PATIENTS AND

METHODS

Longitudinal study from March 2002 to January 2006 of patients treated by this new surgical procedure. Postoperative visits, including an interview and a physical examination were made at two, six and 12 months and annually thereafter. The minimal required follow-up time was 12 months up to January 2007.

RESULTS

Seventy-eight patients were included. Three cases of intraoperative bleeding occurred. In these cases no transfusion was required and no complications were observed later on. The mean hospital stay was five days (range 3-9). The mean follow-up time was 20.36 months (range 12-48). Six recurrences were observed in the medial compartment (8%) and two anterior recurrences (2%). There was no recurrence in the posterior compartment. New-onset moderate dyspareunia was noted in 13% of the cases and a severe in two cases. No erosion occurred.

DISCUSSION AND

CONCLUSION

The analysis of our experience shows that vaginal vault suspension by posterior transobturator approach is a safe and simple procedure, and demonstrates its median efficacy. Further, this study should confirm these results over the long-term follow-up.