FUNCTIONAL OUTCOMES OF TWO AUGMENTED HYSTEROPEXY TECHNIQUES

Study design, materials and methods 40 women with Stage ≥2 prolapse who underwent sacrospinous hysteropexy and allograft augmented anterior colporrhaphy (Group I) were compared with 71 women who underwent a bilateral anterior sacrospinous hysteropexy and anterior colporrhaphy with polypropylene mesh augmentation of the anterior compartment (Group II). Comparisons were made at a median of 16.6 and 12.5 months in Group I and II, respectively. The allograft and mesh were secured using single permanent sutures placed 1.5 cm medial to the ischial spines on both the right and left sacrospinous ligament (SSL). Each SSL suture was secured to both the allograft and polypropylene mesh to a fixation point on the ipsilateral vaginal apex located 1cm lateral to the cervix on both sides, simultaneously suspending the vaginal apices in both groups. In group I the allograft was also secured to the arcus tendineus fascia pelvis ATFP bilaterally. In Group II, the polypropylene mesh was approximated over the anterior colporrhaphy site distally and not anchored to the ATFP. Midurethral sling and posterior colporrhaphy procedures were performed if indicated. Women reported dyspareunia on Likert scales and completed the Pelvic Floor Distress Inventory short form (PFDI-20), as well as the Pelvic Organ Prolapse/ Urinary Incontinence Sexual Questionnaire (PISQ-12) before and after surgery. Change in total and individual scores were evaluated using signed rank test. McNemar’s test was used to assess dyspareunia Likert scales pre and postoperatively.