scholarly journals The effectiveness of surgical procedures to prevent post-hysterectomy pelvic organ prolapse: a systematic review of the literature

2020 ◽  
Author(s):  
Greta Lisa Carlin ◽  
Barbara Bodner-Adler ◽  
Heinrich Husslein ◽  
Magdalena Ritter ◽  
Wolfgang Umek
Keyword(s):  
Systematic Review ◽  
Pelvic Organ Prolapse ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
De Novo ◽  
Pelvic Organ ◽  
Complete Analysis ◽  
Cochrane Library ◽  
Published Data ◽  
Review Of The Literature

Abstract Introduction and hypothesis Hysterectomy is one of the most commonly performed gynecological surgical procedures. One of the long-term risks associated with hysterectomy is the occurrence of pelvic organ prolapse (POP). To prevent post-hysterectomy POP, several suspension procedures are routinely performed at the time of hysterectomy. We performed a systematic review of published data in order to define the most effective surgical procedures for the prevention of post-hysterectomy POP. Methods We performed a systematic review of the literature by searching PubMed, the Cochrane Library, EMBASE, Ovid MEDLINE, and clinicaltrials.gov up to 24 May 2020. The search strategy included the keywords hysterectomy, post-hysterectomy, prolapse, colposuspension, culdoplasty, McCall, and combinations thereof. The inclusion criterion was a surgical procedure at the time of hysterectomy to prevent de novo POP. The outcome was incidence of post-hysterectomy POP. Results Six out of 553 retrieved studies met the methodological criteria for complete analysis. In this review, 719 women aged over 18 years were included. Only 2 studies were designed as prospective trials; however, only 1 compared women undergoing a procedure at the time of hysterectomy with controls. The prevalence of post-hysterectomy prolapse varied from 0% to 39%. Conclusion A systematic review of published literature suggests that performing variations of McCall culdoplasty at the time of hysterectomy might be the most effective prophylactic surgical procedure for preventing post-hysterectomy pelvic organ prolapse.

scholarly journals Modified laparoscopic lateral suspension with a five-arm mesh in pelvic organ prolapse surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eren Akbaba ◽  
Burak Sezgin
Keyword(s):  
Pelvic Organ Prolapse ◽  
De Novo ◽  
Pelvic Organ ◽  
Laparoscopic Technique ◽  
Life Questionnaire ◽  
Advanced Stage ◽  
Posterior Compartment ◽  
Anterior Compartment ◽  
Mesh Graft ◽  
Laparoscopic Lateral Suspension

Abstract Background Laparoscopic lateral suspension (LLS) is a laparoscopic technique used to treat pelvic organ prolapse (POP) in apical and anterior compartment defect with the use of a synthetic T-shaped mesh graft. The posterior compartment is repaired using a second mesh or a procedure along with LLS, such as posterior colporrhaphy. The aim of this study was to evaluate the clinical results of LLS for POP using a five-arm mesh instead of a T-shaped mesh graft to repair the defect of the posterior compartment in addition to the apical and anterior compartments. Methods Data from 37 patients with a diagnosis of advanced-stage (≥ 3) POP undergoing LLS with the use of a five-arm mesh were retrospectively analysed. Pre-operative and post-operative examinations and, surgical outcomes were determined. The results of measurements and examinations, reoperation rates, erosion rates, lower urinary tract symptoms, and complications were analysed. The Prolapse Quality of Life Questionnaire (P-QOL) was also used. Results The median post-operative follow-up was 20 (13–34) months. There was a significant improvement in POP-Q scores in all treated compartments, with overall objective cure rates of 94.5% for the apical compartment, 86.4% for the anterior compartment, and 91.8% for the posterior compartment. The median operative time was 96 (76–112) minutes. The median length of hospitalization was 2 (1–3) days. A significant improvement in vaginal bulge, urinary urgency, incomplete voiding, urinary frequency, and constipation was observed after surgery. The sexuality among patients increased from 13 (35.1%) preoperatively to 22 (59.4%) post-operatively. De novo stress urinary incontinence developed in 7 (18.9%) patients. The P-QOL scores improved significantly after surgery. Conclusions In advanced-stage POP patients, the posterior compartment damage can also be repaired in LLS with the use of a single five-arm mesh without the need for an additional procedure, and the recurrence rate can be reduced.

scholarly journals Pelvic-Floor Dysfunction Prevention in Prepartum and Postpartum Periods

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 387
Author(s):  
Karolina Eva Romeikienė ◽  
Daiva Bartkevičienė
Keyword(s):  
Clinical Trials ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Randomized Clinical Trials ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
Cochrane Library ◽  
Muscle Training

Every woman needs to know about the importance of the function of pelvic-floor muscles and pelvic organ prolapse prevention, especially pregnant women because parity and labor are the factors which have the biggest influence on having pelvic organ prolapse in the future. In this article, we searched for methods of training and rehabilitation in prepartum and postpartum periods and their effectiveness. The search for publications in English was made in two databases during the period from August 2020 to October 2020 in Cochrane Library and PubMed. 77 articles were left in total after selection—9 systematic reviews and 68 clinical trials. Existing full-text papers were reviewed after this selection. Unfinished randomized clinical trials, those which were designed as strategies for national health systems, and those which were not pelvic-floor muscle-training-specified were excluded after this step. Most trials were high to moderate overall risk of bias. Many of reviews had low quality of evidence. Despite clinical heterogeneity among the clinical trials, pelvic-floor muscle training shows promising results. Most of the studies demonstrate the positive effect of pelvic-floor muscle training in prepartum and postpartum periods on pelvic-floor dysfunction prevention, in particular in urinary incontinence symptoms. However more high-quality, standardized, long-follow-up-period studies are needed.

Cognitive assessment tools in Asia: a systematic review

2015 ◽  
Vol 28 (2) ◽  
pp. 189-210 ◽  
Author(s):  
Roshaslina Rosli ◽  
Maw Pin Tan ◽  
William Keith Gray ◽  
Pathmawathi Subramanian ◽  
Ai-Vyrn Chin
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
De Novo ◽  
Assessment Tools ◽  
Screening Tools ◽  
Cochrane Library ◽  
Future Research ◽  
Asian Populations ◽  
Keywords Dementia

ABSTRACTBackground:The prevalence of dementia is increasing in Asia than in any other continent. However, the applicability of the existing cognitive assessment tools is limited by differences in educational and cultural factors in this setting. We conducted a systematic review of published studies on cognitive assessments tools in Asia. We aimed to rationalize the results of available studies which evaluated the validity of cognitive tools for the detection of cognitive impairment and to identify the issues surrounding the available cognitive impairment screening tools in Asia.Methods:Five electronic databases (CINAHL, MEDLINE, Embase, Cochrane Library, and Science Direct) were searched using the keywords dementia Or Alzheimer Or cognitive impairment And screen Or measure Or test Or tool Or instrument Or assessment, and 2,381 articles were obtained.Results:Thirty-eight articles, evaluating 28 tools in seven Asian languages, were included. Twenty-nine (76%) of the studies had been conducted in East Asia with only four studies conducted in South Asia and no study from northern, western, or central Asia or Indochina. Local language translations of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were assessed in 15 and six studies respectively. Only three tools (the Korean Dementia Screening Questionnaire, the Picture-based Memory Intelligence Scale, and the revised Hasegawa Dementia Screen) were derivedde novofrom Asian populations. These tools were assessed in five studies. Highly variable cut-offs were reported for the MMSE (17–29/30) and MoCA (21–26/30), with 13/19 (68%) of studies reporting educational bias.Conclusions:Few cognitive assessment tools have been validated in Asia, with no published validation studies for many Asian nations and languages. In addition, many available tools display educational bias. Future research should include concerted efforts to develop culturally appropriate tools with minimal educational bias.

Sign in / Sign up

Export Citation Format

Share Document