Assessment treatment outcome of sacrospinous ligament fixation for pelvic organ prolapse patients at Jimma Medical Center and Shenen Gibe hospital, Jimma, Southwest Ethiopia; A prospective cohort study design.

Abstract

Background: Pelvic organ prolapse (POP) is one of the sub-component of pelvic floor dysfunction (PFD) which is a major health issue affecting approximately 50% of parous women over 50 years of age, 20% of adult women, with a lifetime prevalence risk of 30 –50% and the risk increases as age advances. POP is the descent of one or more of the pelvic organs due to the weakness of supportive structures and resulting in a herniation into the vaginal cannel. It is primarily a common gynecological condition that also considered as a medical, mental and social problem, deeply rooted with poor health services and socio-cultural beliefs affecting women of both child bearing age and post-menopausal age. Worldwide, POP occurs in about 316 million women (9.3% of all females) and estimated to be diagnosed among one in four women. Despite, sacrospinous ligament fixation (SSLF) is one of the most frequently practiced and an appropriate surgical interventions for POP patients to maintain normal vaginal length and pelvic floor repair, some complications are still inevitable postoperatively which needs to be explored and managed accordingly. Objective: The present study aimed to assess possible complications and the recurrence of vaginal vault prolapse, and associated factors after surgical interventions of SSLF among POP patients in Jimma medical center and Shenen Gibe hospital. Materials and methods: Institutional based prospective cohort study design was employed among 55 POP patients for whom surgical intervention (SSLF) was done in 2018 and 2019 to assess possible short term and long term complications including recurrence rate after follow-up for 12 months. A structured questionnaire was used to collect patient profiles that obtained by history, physical examination and laboratory investigations. Complication/s of surgery was assessed by objective POP quantitation system (POP-Q) and a subjective satisfaction rate was assessed by a validated pelvic quality of life questionnaire (P-QoL/D) at different end points during the follow-up process. A successful surgical outcome was considered when women had ―optimal‖ or ―satisfactory‖ (POP-Q stage 0 or 1 and subjectively respond better than before surgery). The data was entered in to Epidata version 4.3.1 and finally exported to SPSS version 22 for further analysis. Descriptive and analytical statistical analysis was applied to express the finding and was reported by using tables, figures and narrations. A p-value of <0.05 was declared as statistically significant.