Abstract

To compare Vaginal hysterectomy with prophylactic sacrospinous ligament fixation with vaginal hysterectomy alone in terms of 1. Intra-operative and post-operative complications. 2. One year anatomical and functional outcomes in patients who had stage 3 and stage 4 utero-vaginal prolapse. Material and Methods: Patients who underwent vaginal hysterectomy alone and patients who underwent vaginal hysterectomy with prophylactic sacrospinous ligament fixation during 01 august 2020 to 30 august 2022 for stage 3 and stage 4 uterovaginal prolapse were studied for their intra-operative, immediate post-operative complications and followed up to one year to know the anatomical and functional outcomes of the surgical procedures. Thirty patients from each group were analyzed. Results: There was no significant difference in the occurrence of complications in both the groups in the intra-operative and immediate post op period (χ2 = 0.883, p=0.347, df= 1). There was a significant improvement in the quality of sexual life among patients who underwent Vaginal hysterectomy with sacrospinous ligament fixation (Fischer’s Exact p value = 0.003). Complications were significantly higher among patients who had undergone vaginal hysterectomy alone (χ2 = 4.287, p=0.038, df= 1). Most important was the vaginal vault prolapse which was seen among 8 out of the 30 patients underwent vaginal hysterectomy alone when compared to zero patients in vaginal hysterectomy with sacrospinous ligament fixation. Conclusion: Including sacrospinous ligament fixation after vaginal hysterectomy in repair of 3rd and 4th degree uterovaginal prolapse is a beneficial procedure. However further studies with longer follow up duration and larger sample size are needed.

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