The effect of sacrospinous ligament fixation during vaginal hysterectomy on postoperative de novo stress incontinence occurrence: a prospective study with 2-year follow-up

Abstract

Background/aim: To investigate the risk of de novo stress urinary incontinence (SUI) occurrence in women who were treated for pelvicorgan prolapse (POP) with sacrospinous ligament fixation (SSLF) in addition to vaginal hysterectomy (VAH) and antero-posteriorcolporrhaphy (CAP) over a 24-month follow-up period.Materials and methods: A prospective randomized study was designed. Women without occult or obvious SUI were randomized intoeither one of the study groups: Group 1: VAH + CAP, and Group 2: VAH + CAP + SSLF. Postoperatively, the patients were reevaluatedfor de novo SUI occurrence.Results: A total of 150 women were analyzed [G1 = VAH + CAP (n: 77) and G2 = VAH + CAP + SSLF (n: 73)]. Mean age, parity, bodymass index, menopausal status, and preoperative POP degree, grade 1 and grade 2-3 cystocele and rectocele frequencies were similarbetween the 2 groups. During follow-up period, de novo SUI developed in 7 patients (9.1%) of Group 1, and in 6 patients (8.2%) ofGroup 2 (P > 0.05). In Groups 1 and 2, POP recurrence occurred in 5 (6.4%) vs. 1 (1.3%) cases,respectively (P < 0.05).Conclusion: In patients undergoing surgery for POP, the addition of SSLF did not result in an increased rate of de novo SUI. Carefulpatient selection, and informing the patients about the risks and benefits of the planned surgical procedure are essential steps in eachcase of POP.