Pelvic organ prolapse recurrence in young women undergoing vaginal and abdominal colpopexy

2019 ◽  
Vol 31 (12) ◽  
pp. 2661-2667
Author(s):  
Lisa C. Hickman ◽  
Misha C. Tran ◽  
Emily R. W. Davidson ◽  
Mark D. Walters ◽  
Cecile A. Ferrando
Keyword(s):  
Pelvic Organ Prolapse ◽  
Young Women ◽  
Pelvic Organ ◽  
Prolapse Recurrence

Assessing pelvic organ prolapse recurrence after minimally invasive sacrocolpopexy: does mesh weight matter?

2021 ◽  
Author(s):  
Lauren E. Giugale ◽  
Molly M. Hansbarger ◽  
Amy L. Askew ◽  
Anthony G. Visco ◽  
Jonathan P. Shepherd ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Minimally Invasive ◽  
Pelvic Organ ◽  
Prolapse Recurrence

scholarly journals Pelvic organ prolapse surgical training program in Bangladesh and Nepal improves objective patient outcomes

2020 ◽  
Author(s):  
Barbara Hall ◽  
Judith Goh ◽  
Maqsudul Islam ◽  
Anubha Rawat
Keyword(s):  
Pelvic Organ Prolapse ◽  
Training Program ◽  
Patient Outcomes ◽  
Surgical Training ◽  
Pelvic Organ ◽  
Vaginal Repair ◽  
Low Resource ◽  
Prolapse Recurrence ◽  
Surgical Training Program

Abstract Introduction and hypothesis The DAK Foundation (Sydney) has facilitated pelvic organ prolapse (POP) repairs performed by local gynecologists for underprivileged women in Bangladesh and Nepal since 2014. Initially, there was no long-term patient follow-up. When 156 patients were examined at least 6 months after their surgery, an unacceptably high rate of prolapse recurrence and shortened vaginas was identified. This demonstrated the need for surgical up-skilling in both countries. Our hypothesis is that the introduction of a surgical training program in low-resource countries can significantly improve patient outcomes after pelvic floor surgery. Methods One-on-one surgical re-training was undertaken to up-skill the gynecologists in fascial vaginal repair and vaginal apical reconstruction utilizing sacrospinous fixation (SSF). Following the surgical up-skilling, a further 289 women (between 6 and 18 months post-operatively) were examined to determine patient outcomes. Outcome measures were: Prolapse recurrence: POPQ (pelvic organ prolapse quantification [1]) ≥ stage 2 Vaginal length < 4 cm Results Prior to implementation of the surgical training program, 76% of patients had recurrent prolapse ≥ stage 2, and 56% had a vagina < 4 cm in length. Following the training program, prolapse recurrence was reduced to 45% with significant reductions in the apical, anterior and posterior compartments. The incidence of unacceptable vaginal shortening was 4%. We could not rely on patient symptoms to determine whether they had recurrences. Conclusion Clinical patient follow-up to determine surgical outcome is essential in low-resource settings. We have demonstrated that surgical up-skilling in vaginal hysterectomy, vaginal repair and introduction of SSF were necessary to achieve acceptable prolapse recurrence rates in our programs in Bangladesh and Nepal.

Long-term pelvic organ prolapse recurrence and mesh exposure following sacrocolpopexy

2020 ◽  
Vol 31 (9) ◽  
pp. 1763-1770 ◽  
Author(s):  
Tonya N. Thomas ◽  
Emily R. W. Davidson ◽  
Erika J. Lampert ◽  
Marie F. R. Paraiso ◽  
Cecile A. Ferrando
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Mesh Exposure ◽  
Prolapse Recurrence

Pelvic organ prolapse recurrence after apical prolapse repair: does obesity matter?

2021 ◽  
Author(s):  
Nina Durchfort Metcalfe ◽  
Lisa M. Shandley ◽  
Marisa Rogers Young ◽  
Michelle Higgins ◽  
Chidimma Abanulo ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Apical Prolapse ◽  
Prolapse Repair ◽  
Prolapse Recurrence

scholarly journals Serious complications and recurrences after pelvic organ prolapse surgery for 2309 women in the VIGI-MESH registry

2021 ◽  
Author(s):  
Xavier Fritel ◽  
Renaud de Tayrac ◽  
Joe de Keizer ◽  
Sandrine Campagne-Loiseau ◽  
Michel Cosson ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Transvaginal Mesh ◽  
Vaginal Repair ◽  
Mesh Placement ◽  
Native Tissue ◽  
Prolapse Recurrence ◽  
Pop Surgery ◽  
Laparoscopic Sacropexy ◽  
One Year

Objective: To assess the incidence of serious complications and reoperations for recurrence after pelvic organ prolapse (POP) surgery and compare the three most common types of repair. Design: Prospective cohort study using a registry. Setting: 19 surgical centres in France. Population: 2309 women participated between 2017 and 2019. Methods: a multivariate analysis including an inverse probability of treatment weighting approach was used to obtain three comparable groups. Main outcome measures: Serious complications and subsequent reoperations for POP recurrence Results: Mean follow-up was 16.6 months. Surgeries included in the analysis were native tissue vaginal repair (N=504), transvaginal mesh placement (692), and laparoscopic sacropexy with mesh (1113). Serious complications occurred among 52 women (2.3%), and reoperation for recurrence was required for 32 (1.4%). At one year, the cumulative weighted incidence of serious complications was 1.8% for native tissue vaginal repair (95% confidence interval 0-3.9), 3.9% for transvaginal mesh (2.0-5.9), and 2.2% for sacropexy (1.1-2.6). Compared with the native tissue vaginal repair group, the risk of serious complications was higher in the transvaginal mesh group (weighted-HR 3.84, 2.43-6.08), and the sacropexy group (2.48, 1.45-4.23), while the risk of reoperation for prolapse recurrence was reduced in both groups (transvaginal mesh [0.22, 0.13-0.39] and sacropexy [0.29, 0.18-0.47]). Conclusions: Laparoscopic sacropexy with mesh appears to have a better risk profile (few serious complications and few reoperations for recurrence) than transvaginal mesh placement (more serious complications) and native tissue vaginal repair (more reoperations for recurrence). These results are useful for informing women and for shared decision making.

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