Enlargement of the genital hiatus is associated with prolapse recurrence in patients undergoing sacrospinous ligament fixation

Alexandra N. Garcia, Ashley Ulker, Alexandra Aserlind, Douglas Timmons, Carlos A. Medina

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To correlate genital hiatus (GH) size with surgical failures in patients undergoing sacrospinous ligament fixation (SSLF) and compare anatomic outcomes after classification based on GH size. Methods: A retrospective review of 81 patients who underwent SSLF for apical prolapse from 2010 to 2016 at a teaching hospital. Anatomical outcome is reported using the Pelvic Organ Prolapse Quantifications System. A comparison of parametric continuous variables was performed using unpaired Student t test. Categorical variables were evaluated using Pearson's χ2 test and Fisher's exact test. A P value <0.05 was considered significant. Results: Among the 81 patients, no difference in age, parity, body mass index, preoperative prolapse stage or follow-up time was noted between those whose surgery succeeded and those with failed surgery. Postoperatively, a widened GH was significantly associated with recurrent prolapse (P < 0.001). When the preoperative size of the GH was dichotomized into widened (≥4 cm) or normal (<4 cm), there was a non-significant (P = 0.444) trend of more failures in the widened GH group. A posterior colporrhaphy did not improve success. Conclusion: Both preoperative and postoperative widened GH correlated with having more surgical failures following SSLF. Importantly, postoperatively a normal size GH was significantly associated with more surgical success.

Original languageEnglish (US)
JournalInternational Journal of Gynecology and Obstetrics
DOIs
StateAccepted/In press - 2021

Keywords

  • apical prolapse
  • genital hiatus
  • prolapse recurrence
  • sacrospinous ligament fixation
  • surgical outcomes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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