VAGINAL LENGTH AND SEXUAL FUNCTION AFTER COLPOPEXY FOR COMPLETE UTEROVAGINAL EVERSION

OBJECTIVE: Our objective was to evaluate vaginal length and sexual function after colpopexy for complete uterovaginal eversion. STUDY DESIGN: Measurements of postoperative vaginal length were performed on 59 patients having various types of repair for complete uterovaginal eversion. Sexual function was evaluated when possible. Controls were 61 normal premenopausal and postmenopausal patients both with and without a uterus. Anatomic measurements from the introitus to the middle of sacrospinous ligament and to the sacral promontory were obtained from 21 fresh autopsy specimens. RESULTS: Average vaginal length for controls was 9.2 cm in premenopausal patients with a uterus and 8.5 cm for patients without a uterus and averaged 8.5 and 8.2 cm, respectively, for postmenopausal patients with and without a uterus. Vaginal length after posterior culdeplasty was 9.2 cm, 8.2 cm after sacrospinous fixation, and 11.3 cm after sacral colpopexy. CONCLUSION: If maximum vaginal length is the objective, it is best maintained with a sacral colpopexy.