Rates and Severity of Complications in Concomitant Sacrospinous Ligament Fixation and McCall Culdoplasty for Apical Support at the Time of Vaginal Hysterectomy

Abstract

Background:

Sacrospinous ligament fixation (SSLF) can accompany vaginal hysterectomy (VH) to counteract post-hysterectomy vault prolapse. This study evaluated the potential complications of simultaneous SSLF in VH patients using the Clavien–Dindo classification system.

Materials and Methods:

In a retrospective cohort study at a large tertiary teaching medical center, women who underwent VH and concomitant McCall Culdoplasty (MC) between 2014 and 2021 were assessed. They were categorized into two groups: the study group (VH, MC, and SSLF) and the control group (only VH and MC). Adverse events within 12 months post-surgery were collected and categorized using the Clavien–Dindo system. A univariate analysis was conducted using SPSS version 23.

Results:

A total of 193 women were included in the analysis; of these, 67 (34.7%) were in the study group and 126 (65.3%) were included in the control group. Rates of perioperative anemia, diabetes mellitus, and HbA1c levels were lower in the study group. Surgical characteristics of both groups were comparable, and no differences were noted in the length of hospitalization and estimated blood loss. Overall complications, as well as minor and major complication rates using the Clavien–Dindo system, were low in both groups. No differences were noted between the groups in rates of readmission within 30 days of surgery.

Conclusions:

SSLF performed concurrently with VH and MC appears to be safe, as it does not increase the risk of perioperative or postoperative complications. This evidence offers reassurance about the safety of the combined procedure and can be helpful in patient consultations preceding VH.