Vaginal Repair of Vault Prolapse

Understanding Vault Prolapse

Vault prolapse is a condition that can occur after a woman has had a hysterectomy, which is the surgical removal of the uterus. The top of the vagina, known as the vaginal vault, can lose its support and start to sag or protrude. This condition can cause discomfort, pelvic pressure, urinary issues, and difficulties with bowel movements and sexual function. To restore the normal position of the vaginal vault and alleviate symptoms, a surgical procedure called sacrospinous fixation is often performed.

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What is Sacrospinous Fixation?

Sacrospinous fixation is a surgical technique used to correct vaginal vault prolapse by attaching the vaginal vault to the sacrospinous ligament, which is a strong ligament located near the spine in the pelvis. This procedure provides support to the vaginal vault and helps maintain its proper position within the pelvic cavity. Sacrospinous fixation can be performed through a vaginal approach, making it less invasive than abdominal surgeries.

The Surgical Procedure

The sacrospinous fixation procedure is typically performed under general or regional anesthesia. Here is an overview of the steps involved:

  1. Preparation: The patient is placed in a lithotomy position (lying on the back with legs supported in stirrups). The surgical area is cleaned and prepped.
  2. Access: An incision is made in the vaginal wall to expose the underlying tissues and the sacrospinous ligament.
  3. Attachment: Sutures are placed through the sacrospinous ligament on one or both sides. These sutures are then used to anchor the vaginal vault to the ligament.
  4. Closure: The vaginal incision is closed with absorbable stitches. Any other necessary repairs, such as addressing concurrent prolapse of the bladder or rectum, may be performed during the same procedure.
  5. Recovery: The patient is monitored in the recovery room before being transferred to a regular hospital room. Most patients can go home within a day or two after surgery, although this can vary based on individual circumstances.

Recovery and Aftercare

After sacrospinous fixation, patients are advised to:

  1. Avoid heavy lifting and strenuous activities for several weeks.
  2. Follow a high-fiber diet and stay hydrated to prevent constipation.
  3. Perform pelvic floor exercises as recommended by their doctor to strengthen the muscles supporting the pelvic organs.
  4. Attend follow-up appointments to monitor healing and ensure the success of the procedure.

Risks and Complications

As with any surgical procedure, sacrospinous fixation carries potential risks, including:

  1. Bleeding or infection
  2. Injury to surrounding organs, such as the bladder or rectum
  3. Pain or discomfort during intercourse
  4. Recurrence of prolapse
  5. Nerve injury or scarring

Discussing these risks with a qualified surgeon can help patients make informed decisions about their treatment.

Choosing the Right Surgeon

For the best outcomes, it is crucial to choose an experienced and skilled surgeon to perform sacrospinous fixation. Dr. Sankar Dasmahapatra is a highly regarded gynecologist and pelvic floor specialist in Kolkata with extensive experience in performing vaginal repair surgeries for vault prolapse. Dr. Dasmahapatra’s expertise and compassionate approach ensure that patients receive the highest quality of care and achieve the best possible results.

By understanding the procedure, benefits, and recovery associated with sacrospinous fixation, women with vaginal vault prolapse can make informed decisions about their treatment options and take steps toward improved pelvic health and quality of life.