Sacrospinous Ligament Fixation of Vaginal Apex for Repair Operation of Uterine Prolapse : Operative Procedure and Postperative Outcome Evaluated with Score System and X-ray Subtraction Colpography

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  • NAGATA,Ichiro
    Department of Obstetrics and Gynecology, National Defense Medical College, Saitama
  • KATO,Koichi
    Department of Obstetrics and Gynecology, National Defense Medical College, Saitama

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  • 子宮脱手術に対する膣上端・仙棘靭帯固定術の導入とそ評価 : 膣脱垂scoreとsubtraction膣重複造影法を用いて

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To preserve a snug vagina with complete repair, sacrospinous ligament fixation (SLF) to the vaginal apex was applied in operations for uterine prolapse from the April of 1983 to the April of 1984. SLF was added to 11 vaginal hysterectomies with anterior and posterior (A-P) colporrhaphy, 1 Manchester operation and 1 A-P colporrhaphy. SLF was performed at the stage of posterior colporrhaphy in each operation. The postoperative outcome was evaluated with a score system and an X-ray subtraction colpography. The score system describes the grade of vaginal relaxation in each part of the vagina before and after the operation. It showed that the vagina was repaired quite well by the SLF especially in the area of the vaginal apex and posterior wall. The subtraction colpography revealed the side view of the vagina and its movement on straining. It suggested that the SLF was a reasonable procedure for the prevention of recurrence. SLF also proved to have wide application to the repair of uterine prolapse including patients desiring the preservation of childbearing capability and elderly or poor-risk patients.

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