The novel technique of post-hysterectomy vaginal vault prolapse repair: Apical sling and "neocervix" formation.
Eur J Obstet Gynecol Reprod Biol
; 214: 11-15, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-28453958
ABSTRACT
OBJECTIVE:
We primarily aimed to evaluate the effectiveness of the novel technique bilateral sacrospinous fixation by monofilament polypropylene apical sling combined with "neocervix" formation in surgical treatment of post - hysterectomy vaginal vault prolapse. The secondary objective was to estimate the impact of the surgery on voiding function and quality of life. STUDYDESIGN:
This prospective study involved 61 women suffering from post-hysterectomy prolapse. We used the following criteria to evaluate the results of surgical treatment results of vaginal examination (POP-Q system), uroflowmetry, bladder ultrasound, validated questionnaires were used. All listed parameters were determined before the surgery and at control examinations in 1, 6, 12 months after the treatment.RESULTS:
Mean operation time was 35min. No cases of intraoperative damage to the bladder/rectum, as well as clinically significant bleeding were noted.At 12-month follow-up anatomical cure rate (≤stage I, POP-Q) was 100%, 94,4% and 100% for vaginal apex, anterior and posterior vaginal walls, respectively. The following long-term complications were noted stress urinary incontinence de novo and urgency de novo were noted in 6.5% and 4,9%, respectively. Statistically significant (P<0.05) improvement in peak flow rate was observed according to uroflowmetry. Comparison of the scores by the questionnaires revealed a significant improvement in the quality of life in the postoperative period.CONCLUSION:
The novel technique combination of the apical sling and purse-string "neocervix" formation appears to be effective and safe method for treatment patients with vaginal vault prolapse. The technique improves voiding function and quality of life.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Procedimentos Cirúrgicos em Ginecologia
/
Prolapso de Órgão Pélvico
Tipo de estudo:
Etiology_studies
/
Observational_studies
Aspecto:
Patient_preference
Limite:
Aged
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Eur J Obstet Gynecol Reprod Biol
Ano de publicação:
2017
Tipo de documento:
Article