De novo symptoms and their impact on life quality in patients following transvaginal reconstructive pelvic surgery with polypropylene mesh.
Clin Exp Obstet Gynecol
; 40(3): 350-5, 2013.
Article
em En
| MEDLINE
| ID: mdl-24283163
ABSTRACT
OBJECTIVE:
To study the de novo symptoms and their impact on life quality in patients that underwent transvaginal reconstructive pelvic surgery (RPS) with polypropylene mesh. MATERIALS ANDMETHODS:
From May 2004 to March 2011, 114 severe pelvic organ prolapse (POP) patients with Stage III-IV by POP-Q system underwent RPS with polypropylene mesh. Patients completed pelvic floor distress inventory short form (PFDI-20) and pelvic floor impact questionnaire short form (PFIQ-7) preoperatively and repeated them at two and six months, and one year postoperatively.RESULTS:
Ninety-six (84%, 96/114), 85 (75%, 85/114), and 77 (68%, 77/114) patients, respectively, completed the questionnaires at two months, six months, and one year postoperatively. All patients had POP-Q staging scoring < or = I at one year after surgery. Nineteen (19.8%, 19/96) patients had mesh exposure at two and six months (7.8%, 6/77) at one year follow-up. Most vaginal and pelvic symptoms, urinary and obstructive defecation bothersome symptoms improved significantly at two months postoperatively and this improvement was maintained at the one year follow-up. Mean score of PFDI-20 and PFIQ-7 all improved significantly postoperatively at two and six months and at one year follow-up (p < 0.01). Fifty percent (48/96) of patients had postoperative de novo symptoms at the two months follow-up predominantly presented with bothersome vaginal discharge (35.4%, 34/96) and pelvic muscle symptoms (20.8%, 20/96). Patients with de novo symptoms had higher postoperative mean POPDI-6 and POPIQ-7 scores (p < 0.05) than those without at the two month follow-up, but no significant difference was seen at the six month and at one year follow-ups. Patients with bothersome vaginal discharge had higher vaginal mesh exposure rate (41.2%, 14/34) than patients without (8.1%, 5/62) (p = 0.0003). One year after operation, 77 (68%) patients completed the non-validated satisfaction questionnaire. Seventy-four (96%, 74/77) patients said that they were either 'very satisfied' or 'satisfied' with the outcome of their surgery, while three (4%, 3/77) reported unsatisfactory results.CONCLUSIONS:
De novo symptoms were common after transvaginal RPS with polypropylene mesh, but most of them were moderate and resolved within six months postoperatively and seldomly had a long-term negative impact on their quality of life. The impact of dyspareunia on patients' sexual function requires further research.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Telas Cirúrgicas
/
Prolapso de Órgão Pélvico
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Aged
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Clin Exp Obstet Gynecol
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
China