Response to letter to editor: “Pelvic floor imaging with MR defecography: correlation with gynecologic pelvic organ prolapse quantification by Swamy et al.”

Objective: To assess the outcomes of surgical repair of anterior apical prolapse using the 6-strap mesh implant. Study Design: The prospective study included 100 patients with genitourinary prolapse. We used advanced 6-strap mesh implant. The results were assessed at 1 (n = 100) and 12 (n = 93) months after surgery. Maximum follow-up was over 4 years. The anatomical outcomes according to the Pelvic Organ Prolapse Quantification system and intraoperative and postoperative complications were assessed. Stage II and higher prolapse was considered to be a recurrence. The quality of life and sexual function were assessed using Pelvic Organ Prolapse Distress Inventory 20, Pelvic Floor Impact Questionnaire 7, and Pelvic Organ Prolapse/Incontinence Sexual Questionnaire 12. Results: Median age was 57 years (34–78 years (95% confidence interval)). All patients had stage III cystocele. The anterior vaginal wall descent in all the patients was associated with uterine descent: 37 (37%), stage II; 60 (60%), stage III; in 3 (3%), stage IV. In eight cases, postoperative de novo stress urinary incontinence developed. The quality of life improved in 93 (93%) women as judged by the Pelvic Floor Distress Inventory 20 data and in 87 (87%) women, according to the Pelvic Floor Impact Questionnaire 7 data. The desirable anatomical result (⩽stage I according to the Pelvic Organ Prolapse Quantification system) was achieved in 97 (97%) patients. With the exception of mesh fragment excision due to erosion (grade 3a), all the complications were classified as grade I according to the Clavien–Dindo classification. Conclusion: Genitourinary prolapse repair using 6-strap mesh is efficacious and relatively safe. The method demonstrates good anatomical results in relation to both anterior and apical prolapses with relatively short-term complications.

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HUBUNGAN ANTARA USIA, PARITAS, PEKERJAAN DAN INDEK MASSA TUBUH DENGAN KEJADIAN PROLAP ORGAN PANGGUL BERDASARKAN SKOR PELVIC ORGAN PROLAPSE QUANTIFICATION

JOURNAL OBGIN EMAS ◽

10.25077/aogj.2.1.39-44.2018 ◽

2019 ◽

Vol 2 (1) ◽

pp. 39-44

Author(s):

Ermawati Ermawati ◽

Hafni Bachtiar

Keyword(s):

Pelvic Organ Prolapse ◽

Case Control Study ◽

Pelvic Organ ◽

Case Control ◽

T Test ◽

Pelvic Organ Prolapse Quantification ◽

Chi Square ◽

Chi Square Test ◽

Control Study

Prolap organ panggul merupakan kondisi yang mempengaruhi kualitas hidup wanita. Prolaps organ panggul ini dapat disebabkan oleh perlukaan sewaktu proses persalinan, proses penuaan, komposisi jaringan pada seorang wanita, batuk- batuk kronis, atau sering melakukan pekerjaan berat. Pengenalan dini prolaps terkait dengan prognosis pemulihan anatomik dan fungsional organ panggul. Hingga kini, penerapannya dalam dunia klinis belum banyak sehingga pelatihan dan pembelajaran lebih lanjut tentang pelvic organ prolapse quantification (POPQ) jelas diperlukan. Penelitian ini dilakukan dengan metode case control study di polikilinik Obgin RSUP. Dr. M. Djamil Padang mulai bulan September 2013 sampai jumlah sampel terpenuhi sebanyak 98 orang. Dengan 49 orang kelompok kontrol dan 49 orang kelompok kasus .Analisis dilakukan untuk menilai hubungan usia, paritas, pekerjaan dan indek massa tubuh dengan kejadian prolap organ panggul berdasarkan skor POPQ. Data disajikan dalam bentuk tabel. Data diuji dengan t test dan chi square test. Jika p<0,05 menunjukan hasil yang bermakna. Terdapat hubungan yang bermakna antara usia dengan kejadian prolap organ panggul dengan (p<0,05) dan OR 27,871.terdapat hubungan yang bermakna antara paritas dengan kejadian prolap organ panggul dengan (p<0,05) dan OR 52,970.Dari analisa statistik pekerjaan tidak bisa di uji secara statistik.indek massa tubuh tidak terdapat hubungan yang bermakna terhadap kejadian prolap organ panggul.(p>0,05)

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Current situation of complications related to reconstructive surgery for pelvic organ prolapse: a multicenter study

International Urogynecology Journal ◽

10.1007/s00192-021-04892-x ◽

2021 ◽

Author(s):

Zhi-jing Sun ◽

Tao Guo ◽

Xiu-qi Wang ◽

Jing-he Lang ◽

Tao Xu ◽

...

Keyword(s):

Patient Satisfaction ◽

Pelvic Organ Prolapse ◽

Pelvic Floor ◽

Reconstructive Surgery ◽

Tissue Repair ◽

Pelvic Organ ◽

Native Tissue Repair ◽

Post Surgery ◽

Management Of Complications ◽

Surgery Delay

Abstract Introduction and hypothesis This study aimed to investigate the evaluation and management of complications after pelvic floor reconstructive surgery for pelvic organ prolapse in China. Methods Complications of pelvic floor reconstructive surgery for pelvic organ prolapses from 27 institutions were reported from November 2017 to October 2019. All complications were coded according to the category-time-site system proposed by the International Urogynecological Association (IUGA) and the International Continence Society (ICS). The severity of the complications was graded by the Clavien-Dindo grading system. Four scales were used to evaluate patient satisfaction and quality of life after management of the complications: the Patient Global Impression of Improvement (PGI-I), the Pelvic Floor Impact Questionnaire Short Form (PFIQ-7), the Pelvic Organ Prolapse Symptom Score (POP-SS), and a 5-point Likert-type scale that evaluated the patient’s choice of surgery. Results Totally, 256 cases were reported. The occurrence of complications related to transvaginal mesh (TVM) and laparoscopic sacrocolpopexy (LSC) had a significantly longer post-surgery delay than those of native tissue repair surgery (p < 0.001 and p = 0.010, respectively). Both PFIQ-7 and POP-SS score were lower after management of complications (p < 0.001). Most respondents (81.67%) selected very much better, much better, or a little better on the PGI-I scale. Only 13.3% respondents selected unlikely or highly unlikely on the 5-point Likert-type scale. Conclusions The occurrence of complications related to TVM surgery and LSC had a longer post-surgery delay than native tissue repair surgery. Long-term regular follow-up was vital in complication management. Patient satisfaction with the management of TVM complications was acceptable.

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Quo Vadis Urogynecology 2020 – Innovative Treatment Concepts for Urinary Incontinence and Pelvic Organ Prolapse

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-1302-7803 ◽

2021 ◽

Vol 81 (02) ◽

pp. 183-190

Author(s):

Gert Naumann

Keyword(s):

Urinary Incontinence ◽

Pelvic Organ Prolapse ◽

Pelvic Floor ◽

Professional Training ◽

Pelvic Floor Dysfunction ◽

Estrogen Therapy ◽

Pelvic Organ ◽

Alloplastic Materials ◽

Wide Range ◽

Quo Vadis

AbstractThe current treatment for urinary incontinence and pelvic organ prolapse includes a wide range of innovative options for conservative and surgical therapies. Initial treatment for pelvic floor dysfunction consists of individualized topical estrogen therapy and professional training in passive and active pelvic floor exercises with biofeedback, vibration plates, and a number of vaginal devices. The method of choice for the surgical repair of stress urinary incontinence consists of placement of a suburethral sling. A number of different methods are available for the surgical treatment of pelvic organ prolapse using either a vaginal or an abdominal/endoscopic approach and autologous tissue or alloplastic materials for reconstruction. This makes it possible to achieve optimal reconstruction both in younger women, many of them affected by postpartum trauma, and in older women later in their lives. Treatment includes assessing the patientʼs state of health and anesthetic risk profile. It is important to determine a realistically achievable patient preference after explaining the individualized concept and presenting the alternative surgical options.

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