The comparison of colpocleisis and sacrospinous ligament fixation surgeries for treatment of vaginal vault prolapse: an observational study.

Abstract

<h4>Objective</h4>This study aimed to compare the surgical outcomes, as well as the intraoperative and postoperative complications, of colpocleisis and sacrospinous ligament fixation (SSLF) in the management of vaginal vault prolapse (VVP) among post-hysterectomy patients.<h4>Methods</h4>A retrospective, observational study was conducted on 49 patients who underwent surgery for VVP at Ankara Bilkent City Hospital between January 2020 and December 2024. Of the 49 patients, 26 (53.1%) underwent colpocleisis surgery and 23 (46.9%) underwent SSLF surgery. Data collected included patient demographics, preoperative and postoperative hemoglobin levels, operation time, hospital stay, and postoperative complications. The study also assessed treatment success and recurrence rates.<h4>Results</h4>The mean age of the patients was significantly higher in the colpocleisis group than the SSLF group (71.5 years <i>vs</i>. 59.9 years, p=0.01). There were no significant differences in hemoglobin drop levels, previous hysterectomy indications and types, or operation times between the two groups (p≥0.05). The mean hospital stay was significantly longer in the colpocleisis group than in the SSLF group (3.2 days <i>vs</i>. 1.6 days, p=0.02). Kaplan-Meier analysis revealed no significant difference in VVP recurrence requiring reoperation between the colpocleisis and SSLF groups (3.8% vs. 13.1%, respectively; p = 0.13).<h4>Conclusion</h4>SSLF and colpocleisis have demonstrated high efficacy in the treatment of vaginal vault prolapse. These surgical approaches are particularly appropriate for elderly patients with significant comorbidities, as they are associated with low complication rates, shorter operative times, and reduced recurrence rates.