Iliococcygeus fixation for the treatment of apical vaginal prolapse: efficacy and safety at 5 years of follow-up

Maurizio Serati, Andrea Braga, Giorgio Bogani, Umberto Leone Roberti Maggiore, Paola Sorice, Fabio Ghezzi, Stefano Salvatore

Research output: Contribution to journalArticlepeer-review


Introduction and hypothesis: Sacrocolpopexy is considered the gold standard treatment for vaginal vault prolapse. However, the vaginal approach is very common, with 80–90 % of procedures being performed via this route. The aim of this study was to evaluate the safety and efficacy of iliococcygeus (ICG) fixation in the treatment of vaginal vault prolapse, with a minimum follow-up of 5 years. Methods: We prospectively enrolled women with symptomatic vaginal vault prolapse (Pelvic Organ Prolapse Quantification [POP-Q] stage ≥2) who were treated with ICG fixation. Subjective success was defined in the case of Patient Global Impression of Improvement ≤ 2 and an absence of bulging symptoms. Objective success was defined as stage of prolapse <2 in all compartments. Overall success rate was defined as women without prolapse symptoms, PGI-I ≤ 2, stage of prolapse <2, and no need for other surgery. All women filled in the Prolapse Quality of Life (P-QOL) questionnaire both at the preoperative visit and at every follow-up visit. Multiple logistic regression was performed to identify factors involved in the risk of recurrent POP. Results: After a median (range) follow-up of 68.8 (60–92) months the subjective, objective, and overall cure rates were 88.6 % (39 out of 44), 84.1 % (37 out of 44), and 84.1 % (37 out of 44) respectively. Only preoperative stage IV vault descensus independently predicted POP recurrence after iliococcygeus fixation (OR: 8.78 [95 % CI: 1.31–9.42]; p <0.001). Conclusions: Iliococcygeus fixation is a safe and effective surgical technique for the treatment of vaginal vault prolapse with long-lasting effectiveness.

Original languageEnglish
Pages (from-to)1007-1012
Number of pages6
JournalInternational Urogynecology Journal and Pelvic Floor Dysfunction
Issue number7
Publication statusPublished - Jul 1 2015


  • Apical prolapse
  • Iliococcygeus
  • Long-term follow-up
  • Pelvic organ prolapse (POP)
  • Sacrocolpopexy

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynaecology

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