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

Abstract

Objective: This study aims 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.

Methods: A retrospective, observational study was conducted on 49 patients who underwent surgery for VVP at a tertiary referral clinic between January 2020 to December 2024. Of the 49 patients, 26 (53.1%) underwent colpocleisis surgery and 23 (46.9%) underwent SSLF surgery. Data collected included patient demographics (age, gravidity, parity), preoperative and postoperative hemoglobin levels, operation time, hospital stay, and postoperative complications. The study also assessed treatment success and recurrence rates.

Results: The mean age of the patients was significantly higher in the colpocleisis group than the SSLF group (71.5 years vs. 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 vs. 1.6 days, P=0.02). While the failure of surgery was higher in the SSLF group than in the colpocleisis group (6.1% vs. 2.0%, respectively), there were no significant differences between the groups (P=0.33).

Conclusion: Sacrospinous ligament fixation (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.