Outcomes study: A comparison of cure rates in 695 patients undergoing sacrospinous ligament fixation alone and with other site-specific procedures: A 16-year study. Discussion

OBJECTIVE: The study was undertaken to compare the results of vaginal fixation from a time when sacrospinous ligament fixation (SSLF) was performed solely or with minimal repair of other defects with the results of SSLF when site-specific defect approaches were performed. STUDY DESIGN: Six hundred ninety-five patients underwent an SSLF over a 16-year period. From 1985 through 1990, minimal attention was paid to other sites because the SSLF appeared to correct all vaginal tract defects (group A = 173). From 1991 through 1994, we realized that our attempts were failing. An anterior and posterior colporrhaphy, and a high ligation of any cul-de-sac were performed when appropriate (group B = 221). From 1995 through 2000, site-specific repairs of all defects were used to care for these patients with prolapse (group C = 301). RESULTS: The anatomic cure rates for the SSLF (when evaluating only the vaginal apex) were calculated for vault fixation. When site-specific repairs were used and all sites repaired anatomically (group C), cure predominated. The X2 calculations for group A compared with group B and group B compared with group C were performed. CONCLUSION: The SSLF technique is still a good option for apical prolapse, does not have to distort the vaginal axis, and is to be used in conjunction with other site-specific repairs.