TREATMENT OF APICAL PROLAPSECOMPARING THE BILATERAL SACROSPINOUS FIXATION WITH A SUTURE CAPTUREDEVICE
E. CORTES1, B. MUNOZ1, J. BARBABOSA 2;
1Urogynecologyand Reconstructive Pelvic Surgery, UMAE "Luis Castelazo Ayala"IMSS, Mexico City, Mexico, 2Obstetrics and GynecologyDepartment, HOSGENAES Secretaría de Marina, Mexico City, Mexico.
Introduction: The sacrospinousfixationis a technique that corrects apical prolapse. This procedurehas a morbidity and recurrence that varies between 5% to 15%. Thecurrent devices offer a smaller dissection and greater access to thesacrospinous ligament with the same anatomic result, and hence, itbecomes essential to evaluate their effectiveness with thetraditional procedures
Objective: To compare the results ofthe treatment of apical prolapse using the traditional Richtertechnique, with the fixation using a suture capture device.
Methods:A comparative, retrospective, longitudinal, and analytical study wasperformed. 30 patients with apical prolapse greater than or equal tograde 2 were included in the study, 15 of which were treated with abilateral sacrospinous attachment using the classical Richtertechnique, and 15 were treated with a sacrospinous attachment via asuture capture device. The duration of the surgery, the amount ofbleeding, the trans and postoperative complications, pain, and theanatomic result after 3 months were compared
Results: Uponanalyzing both groups, the variation in the duration of the surgicalprocedure had a statistically significant difference (p<0.001).There were no significant differences between the pain, the amount ofbleeding, and the trans and postoperative complications. The majorityof patients had undergone some other corrective procedure forprolapse, having been the correction of the anterior compartment themain procedure. In regard to the improvement of the symptoms, therewas no significant difference between both groups, having 80%. As faras the clinical assessment of point C, there was a significantdifference between the pre and postoperative assessment. However,upon comparing both groups, no significant difference wasdiscovered
Conclusions: The bilateral sacrospinous fixationusing a suture capture device is equally effective as the traditionaltechnique. It has as its advantages over the traditional techniquethe possibility of anterior access to the sacrospinous ligament, aswell as a shorter surgical duration
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