scholarly journals Colpocleisis as an obliterative surgery for pelvic organ prolapse: is it still a viable option in the twenty-first century? Narrative review

2021 ◽  
Author(s):  
Magdalena Emilia Grzybowska ◽  
Konrad Futyma ◽  
Aida Kusiak ◽  
Dariusz Grzegorz Wydra
Keyword(s):  
Urinary Tract ◽  
Pelvic Organ Prolapse ◽  
Surgical Techniques ◽  
Pelvic Organ ◽  
First Century ◽  
Complication Rates ◽  
Decision Regret ◽  
Sling Surgery ◽  
Subjective Success ◽  
Stage 1

Abstract Introduction and hypothesis The aims were to review the literature from the last two decades and analyze treatment efficacy and findings of the studies on colpocleisis. Methods A systematic search was conducted within the MEDLINE/PubMed and ClinicalTrials.gov databases, using the following keywords: pelvic organ prolapse (POP), colpocleisis, obliterative, and LeFort. All English full-text prospective and retrospective observational and interventional studies were included. Anatomical and subjective success, surgical techniques, concomitant procedures, complication rates, anesthesia methods, and decision regret were analyzed. Results A total of 237 papers were identified and 49 met the inclusion criteria. Mean patient age was 69.0 ± 8.0 to 84 ± 3.1. Over 90.2% of patients undergoing colpocleisis were diagnosed with POP stage ≥ 3. The follow-up ranged from 30 days to a median of 5 years. Anatomical success, defined as POP-Q stage ≤ 1 and no prolapse beyond the hymen, was achieved in 62.5 to 100% and 87.5 to 100% of all patients respectively. Subjective success ranged from 88% to 100%. Regret over the loss of coital ability ranged from 0% in many studies to 12.9%, general decision regret from 0% to 13.8%. After concomitant midurethral sling surgery, 86.8% to 94% of all patients were continent, with a 0–14% sling revision rate due to urinary retention. Urinary tract infection was the most common postoperative complication (4.3 to 9% confirmed with urine culture, 34.7% based on symptom definition). Bowel (0 to 2.7%) and urinary tract (0 to 9.1%) injuries were the consequences of concomitant procedures. The mortality rates were up to 1.3%. Conclusions Colpocleisis is a heterogeneous procedure, characterized by high subjective and objective success, low coital ability regret, and a low risk of complications.

Renal dysfunction due to advance pelvic organ prolapse

2021 ◽  
Vol 71 (11) ◽  
pp. 2662-2664
Author(s):  
Lubna Razzak ◽  
Sherjeel Saulat
Keyword(s):  
Renal Failure ◽  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Chronic Renal Failure ◽  
Pelvic Organ Prolapse ◽  
Renal Dysfunction ◽  
Pelvic Organ ◽  
Uterovaginal Prolapse ◽  
Irreversible Damage

Uterovaginal prolapse is the downward descent of the pelvic organ, resulting in protrusion of the vagina, uterus, bladder or rectum. The association between POP and hydronephrosis has been shown by various studies, but severe hydronephrosis leads to renal dysfunction are rarely seen. We report a case of 70 years old female with massive vaginal prolapse and chronic renal impairement. She presented with urinary tract infection (UTI) and raised creatinine levels of 4.5mg/dl. After correction of UTI, she surgically managed to relieve her obstructive symptoms. After surgery her creatinine levels drop to 2.0mg/dl but chronic renal failure persisted. Advance stage prolapsed may damage renal function if left untreated. Timely diagnosis and management may prevent irreversible damage to kidneys Continuous...

scholarly journals Ultrasonographic Assessment with Three-Dimensional Mode of the Urethral Compression Effect following Sling Surgery with and without Mesh Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Kun-Ling Lin ◽  
Yung-Shun Juan ◽  
Shih-hsiang Chou ◽  
Cheng-Yu Long
Keyword(s):  
Pelvic Organ Prolapse ◽  
Three Dimensional ◽  
Pelvic Organ ◽  
Short Axis ◽  
Anatomical Changes ◽  
Mesh Surgery ◽  
Sling Surgery ◽  
Perineal Ultrasonography ◽  
Proximal Urethra ◽  
Ultrasonographic Assessment

Background. The aim of this study was to assess anatomical changes in the urethra at rest and during straining following sling surgery with and without transvaginal mesh surgery (TVM) in women with stress urinary incontinence (SUI) with or without pelvic organ prolapse (POP) using three-dimensional ultrasonography. Methods. 76 women with SUI with or without pelvic organ prolapse after sling surgery. They underwent sling surgery alone (S group, n=36) or concomitant TVM (M group, n=40). All patients underwent urinalysis, pelvic examinations, urodynamic study, 3D perineal ultrasonography, and personal interviews before and 1 year after surgery. The urethral area was calculated from the axial plane of perineal ultrasonography by multiplying π by the long and short axes of the urethral lumen. Results. The axial area of the middle and distal urethra during straining was significantly smaller than at rest in both groups (P<0.001). In addition, the length of the short axis of the proximal urethra was significantly shorter in those undergoing sling surgery alone during straining compared with those undergoing concomitant sling and mesh surgery (P<0.001). Conclusions. There was a greater impact on the proximal urethra in women who underwent sling surgery alone than those who underwent sling and TVM surgery together.

Urinary Tract Infection and Pelvic Organ Prolapse—an Association that Needs Further Clarification

2020 ◽  
Vol 15 (4) ◽  
pp. 320-324
Author(s):  
Gláucia Miranda Varella Pereira ◽  
Luiz Gustavo Oliveira Brito ◽  
Paulo Cesar Rodrigues Palma
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Pelvic Organ Prolapse ◽  
Tract Infection ◽  
Pelvic Organ

Pelvic organ prolapse: surgical repair – Helpful as a therapy for urinary tract infections?

2002 ◽  
Vol 59 (9) ◽  
pp. 469-474
Author(s):  
Eberhard ◽  
Geissbühler
Keyword(s):  
Urinary Tract ◽  
Pelvic Organ Prolapse ◽  
Urinary Tract Infections ◽  
Operative Therapie ◽  
Konservative Therapie ◽  
Surgical Repair ◽  
Pelvic Organ ◽  
Anatomische Rekonstruktion ◽  
Rezidivierende Harnwegsinfekte ◽  
Tract Infections

Urogynäkologische Deszensusbeschwerden und chronisch rezidivierende Harnwegsinfekte kommen häufig gemeinsam vor. Zurückzuführen ist dies auf gleiche ätiologische Faktoren (hormonmangelbedingte Atrophie, neurogene Erkrankungen, Stoffwechselstörungen) und auf direkte mechanische Einflüsse des Deszensus auf die Harnröhrenfunktion (Abknicken mit Miktionsstörungen und Restharnanstieg bei großer Zystozele oder Stressinkontinenz und Drangsymptomatik bei großer Urethrozele). Die Therapie soll konservativ beginnen und möglichst alle ätiologischen Faktoren angehen. Bausteine der konservativen Therapie sind Östrogene, Beckenbodentraining, Pessare, Trink- und Miktionstraining und Sanierung der urogenitalen Infektkette [1]. Führt die konservative Therapie innert einiger Monate nicht zur Heilung oder zur befriedigenden Besserung, ist in der Regel eine operative Therapie zu empfehlen. Dabei sind moderne Operationsmethoden zu wählen, die nicht nur eine anatomische Rekonstruktion sondern auch eine funktionelle Restitution zum Ziel haben, d.h. Kontinenz, gute Blasenentleerung und Defäktion und schmerzfreie Kohabitation.

scholarly journals Urinary Complication Following Cystocele Repair in Pelvic Organ Prolapse

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Sweety Shrestha
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Pelvic Organ Prolapse ◽  
Tract Infection ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Reproductive Age ◽  
Medical Sciences ◽  
Uterine Descent ◽  
Tract Infections

Aims: Pelvic organ prolapse is a common condition in our country which affects the quality of life of many women. After vaginal operations for genital prolapse, there is increased chance of urinary tract infections, retention of urine and re-catheterization.The objective of this study is to evaluate  women with cystocele  in terms of clinical profile, different modalities of treatment and the complication  following repair.Methods: It is a descriptive study carried out amongst 80 cases of cystocele irrespective of associated uterine descent and stress incontinence of urine in College Of Medical Sciences – Teaching Hospital, Nepal from 1/9/201l to 30/10/2013.Results: During the study, 80 women  with  cystocele  were enrolled. Majority of the women (66.3%, n =53) with cystocele were within 15 to 45 years and 53.8% (n=43) of them had parity beyond 5. Among these women, 51.4% (n=41) had second degree cystocele  and 23.8% (n=19) had stress urinary incontinence. Majority of the women (58.8%, n=40) underwent vaginal hysterectomy with pelvic floor repair. Following surgery, the most common complication was urinary tract infection (14.7%, n = 10).Conclusions: In this study, majority of the cases with cystocele were in the reproductive age with parity beyond 5 while maximum number of the women with cystocele had associated third degree uterocervical descent. Urinary tract infection was the commonest complication following surgical treatment followed by retention of urine. 

scholarly journals Post void residue in women with pelvic organ prolapse: a prospective observational study

2019 ◽  
Vol 8 (4) ◽  
pp. 1520
Author(s):  
Nanthini Saravanan ◽  
Aruna N. Kekre ◽  
Mahasampath Gowri S.
Keyword(s):  
Quality Of Life ◽  
Urinary Tract ◽  
Pelvic Organ Prolapse ◽  
Lower Urinary Tract ◽  
Pelvic Organ ◽  
P Value ◽  
Residual Volume ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Background: The objective of the present study was to observe the post void residual volume (PVRV) in women with pelvic organ prolapse (POP) pre and postoperatively and to correlate stage of prolapse with lower urinary tract symptoms and quality of life in women with pelvic organ prolapse.Methods: This is a prospective observational cohort study of 100 women with symptomatic pelvic organ prolapse of stage II or greater. Patients were admitted for Vaginal hysterectomy with pelvic floor repair for pelvic organ prolapse in Gynaecology Department at Christian Medical College Hospital, Vellore, India over one year were recruited. This study was approved by the institutional review board and ethical committee of the hospital. Pre- and post-operative PVR were measured. The statistical analysis was done by using SPSS version 21 and P value < 0.05 was considered as statistically significant.Results: In this study 100 patients were recruited and 11% of women had pre-operative high post void residual volume of more than 100 ml. Stages of POP did not correlate with severity of LUTS and QOL. Pre-operative elevated PVR resolved post operatively in 91%, the P value <0.000 which was highly significant.Conclusions: 11% of women had preoperative high PVR. Stages of POP did not correlate with severity of lower urinary tract symptoms (LUTS) and quality of life(QOL). Pre-operative elevated PVR resolved post operatively in 91%, the P value < 0.000 which was highly significant. Majority of the patient with severe pelvic organ prolapse had elevated pre-op PVR which resolved post- operatively after surgical correction.

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