Vaginal Vault Prolapse Surgical Treatment (VVPST)

Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital

Status: Completed

Conditions: Pelvic Floor Prolapse; Vaginal Vault Prolapse

Treatments: Procedure: vNOTES high uterosacral ligament suspension; Procedure: Laparoscopic lateral suspension

Study type: Observational

Funder types: Other

Identifiers

NCT06792331

VVPST

Details and patient eligibility

About

Since apical support is the mainstay of vaginal cuff restoration, sacrocolpopexy is still accepted as the gold standard technique in vaginal vault prolapse (VVP). The increased risk of surgical morbidity in the abdominal approach has prompted the interest in minimally invasive surgery. Laparoscopic lateral suspension (LLS) using mesh is an efficient alternative technique for apical support. In addition, vaginal approaches have been used in cuff prolapsus surgery for many years. Uterosacral ligaments are strong native tissues used in cuff surgery and apical support. In recent years, Vaginal Natural Orifice Transluminal Endoscopic Surgery (VNOTES) has offered advantages particularly complications related to the ureter over the traditional transvaginal uterosacral ligament suspension in cuff restoration.

Full description

Hysterectomy is one of the common surgical procedures in current gynecology practice and is a risk factor for vault prolapse. Since apical support is the mainstay of vaginal cuff restoration, sacrocolpopexy is still accepted as the gold standard technique in vaginal vault prolapse (VVP). The increased risk of surgical morbidity in the abdominal approach has prompted the interest in minimally invasive surgery. Laparoscopic lateral suspension (LLS) using mesh is an efficient alternative technique for apical support. In addition, vaginal approaches have been used in cuff prolapsus surgery for many years. Uterosacral ligaments are strong native tissues used in cuff surgery and apical support. In recent years, Vaginal Natural Orifice Transluminal Endoscopic Surgery (VNOTES) has offered advantages particularly complications related to the ureter over the traditional transvaginal uterosacral ligament suspension in cuff restoration. Lack of incision pain, better cosmetic results, and direct visualization of important structures such as the rectum and ureter that cannot be obtained with the traditional transvaginal approach are important advantages of vNOTES approach.

Enrollment: 64 patients

Sex: Female

Ages: 40 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Women with vaginal vault prolapse

Exclusion criteria

• Women who have previously undergone surgical treatment for pelvic organ prolapse
• Women who needed additional surgery due to anterior or posterior prolapse or stress incontinence
• Pelvic inflammatory disease
• Suspected gynecological malignancy
• Rectovaginal endometriosis
• obliterated rectovaginal space detected on pelvic examination.

Trial design

64 participants in 2 patient groups

Women with vNOTES high uterosacral ligament suspension

Description:

Symptomatic women aged 40-80 years old with ≥ stage 2 vault prolapse who underwent vNOTES high uterosacral ligament suspension and laparoscopic lateral suspension.

Treatment:

Procedure: vNOTES high uterosacral ligament suspension

Women with laparoscopic lateral suspension.

Description:

Symptomatic women aged 40-80 years old with ≥ stage 2 vault prolapse who underwent laparoscopic lateral suspension.

Treatment:

Procedure: Laparoscopic lateral suspension