O132 POSTERIOR INTRAVAGINAL SLINGPLASTY FOR VAGINAL PROLAPSE: 7 YEARS FOLLOW-UP

Objective. To investigate the differences in efficacy, postoperative complications, and patient satisfaction between posterior intravaginal slingplasty (PIVS) and unilateral sacrospinous ligament fixation (SSLF) procedures. Study Design. A retrospective study of thirty-three women who underwent PIVS or SSLF treatment for vaginal vault prolapse in Oulu University Hospital. The patients were invited to a follow-up visit to evaluate the objective and subjective outcomes. Median follow-up time was 16 months (range 6–52). The anatomical outcome was detected by the Pelvic Organ Prolapse Quantification (POP-Q) system. Information on urinary, bowel, and sexual dysfunctions and overall satisfaction was gathered with specific questionnaire. The data were analyzed using Mann-Whitney U test and Fisher’s exact test. Results. Mesh erosion was found in 4 (25%) patients in the PIVS group. Anatomical stage II prolapse or worse (any POP-Q point ≥−1) was detected in 8 (50%) patients in the PIVS group and 9 (53%) patients in the SSLF group. Overall satisfaction rates were 62% and 76%, respectively. Conclusion. The efficacy of PIVS and SSLF is equally poor, and the rate of vaginal erosion is intolerably high with the PIVS method. Based on our study, we cannot recommend the usage of either technique in operative treatment of vaginal vault prolapse.

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A modified technique for paravaginal repair for the treatment of anterior vaginal prolapse and cystocele: a retrospective study

10.21203/rs.3.rs-31364/v1 ◽

2020 ◽

Author(s):

Shuai Huang ◽

Qiubo Lv ◽

Ye Li ◽

Min Li ◽

Sichen Zhang

Keyword(s):

Case Series ◽

Vaginal Prolapse ◽

Cure Rate ◽

Modified Technique ◽

Sacrospinous Ligament Fixation ◽

Paravaginal Repair ◽

Grade Ii ◽

Anterior Vaginal Prolapse ◽

Objective Cure

Abstract Background We aimed to determine the efficacy and safety of a modified protocol for paravaginal repair for treating symptomatic paravaginal defect cystocele. Methods This study was an observational case series of 98 consecutive female patients, referred to our hospital between June 2014 and May 2018, with symptomatic grade II to IV paravaginal defects and cystocele. Our modified technique for paravaginal repair is based on the conventional protocol but incorporates reverse bridge repair and the cross-stitching of bilateral sutures. The curative effect of this new technique was evaluated subjectively and objectively during postoperative follow-up. Results All operations were successful. Patients were followed up for 12 to 48 months, until June 2019; the mean follow-up period was 32.4 months. Three months after surgery (98 cases), the subjective cure rate was 100%; in each case, the top of the vagina lay above the level of the sciatic spine. The objective cure rate was 100%. The objective cure rate was 94.9% (93 cases) twelve months after surgery (98 cases), 91.0% (61 cases) twenty-four months after surgery (71 cases), and 76.2% (16 cases) forty-eight months after surgery (21 cases). Four cases required a second round of surgery; three of these cases were treated with sacrocolpopexy, and one case was treated with sacrospinous ligament fixation. Conclusion Our modified technique for paravaginal repair was safe and effective for the treatment of anterior vaginal prolapse and cystocele, as confirmed by the results observed over a mean follow-up period of 32.4 months.

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Outcomes of Single Incision Anchored Anterior Vaginal Mesh Repair for Recurrent Vaginal Prolapse

Current Opinion in Gynecology and Obstetrics ◽

10.18314/cogo.v3i1.1620 ◽

2020 ◽

Vol 3 (1) ◽

pp. 384-393

Author(s):

Loganathan J ◽

Fayyad AM

Keyword(s):

Mesh Repair ◽

Single Incision ◽

Vaginal Prolapse ◽

Vaginal Mesh ◽

Lightweight Mesh ◽

Life Questionnaire ◽

Medical Systems ◽

Anterior Vaginal Prolapse ◽

Vaginal Mesh Repair

Objective: To report the safety and efficacy of single incision anchored anterior vaginal mesh repair for women with recurrent anterior vaginal prolapse.Methods: Retrospective study of women with recurrent anterior vaginal prolapse, Stage 2 or beyond, who underwent single incision anchored vaginal mesh repair with Anterior Elevate (American Medical Systems, Minnetonka, USA) between June 2012 and October 2016. Pre-operatively, the Prolapse Quality-of-Life questionnaire (P-QOL) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (PISQ-12) were completed. Post-operatively, women completed the P-QOL, PISQ-12 and the global impression of improvement questionnaire (PGI-I). Preoperative POP-Q and post operative POP-Q examination at up to 24 months follow up were recorded. At average follow up of 36 months, participants were interviewed via telephone using questions from the P-QOL, PISQ and PGI-I.Results: 45 women had single incision anterior vaginal mesh kit repair for recurrent prolapse. Postoperatively, 85% of women reported cure of their prolapse symptoms. At 24 months, 80.0% had POP-Q stage 0 or 1 in the anterior compartment, and 93.8% achieved anatomical cure of apical prolapse (point C above 0). During structured telephone interview at mean follow up of 36 months, on PGI-I, 70% reported feeling ‘much better’ or ‘very much better’.Conclusion: Vaginal surgery using single incision lightweight mesh kits can be an effective approach for women with recurrent anterior vaginal prolapse, resulting in subjective and objective cure rates of over 80% with reasonable safety profile up to 60 months postoperatively.

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Assessing the treatment outcome of various reproductive diseases of animals by follow-up monitoring in VTH, BAU

10.33109/bjvmjd1812 ◽

2019 ◽

pp. Jayonta-Bhattacharjee

Author(s):

A. K. Boishakhi ◽

R. K. Barson ◽

N. S. Juyena ◽

J. Bhattacharjee

Keyword(s):

Genital Tract ◽

Domestic Animals ◽

Vaginal Prolapse ◽

Reproductive Efficiency ◽

Reproductive Disorders ◽

Uterine Infection ◽

Standard Procedures ◽

Reproductive Disease ◽

Careful Management

Background: Reproductive disorders have been found to be a major reason for decreased reproductive efficiency in animals. The present study was conducted to determine the effectiveness of different treatment for various reproductive diseases of domestic animals in Veterinary Teaching Hospital (VTH), Bangladesh Agricultural University (BAU), Mymensingh. Methods: A total of 100 animals were registered for treatment during the study period. Among those 59 cattle, 9 goats and 1 turkey were treated for reproduction related diseases. On the other hand, 28 cows and 3 goats were bought for regular pregnancy diagnosis. Standard procedures were followed for the diagnosis and treatment of the diseases. Results: Among the reproductive diseases of cattle, conception failure was 37.29% (n=22), uterine infection was 33.89% (n=20), anestrous was 13.56% (n=8), repeat breeding was 5.08% (n=3), vaginal prolapse was 3.39% (n=2), pastular vulvo-vaginitis was 1.69% (n=1) and ovarian hypoplasia was 1.69% (n=1). Only 2 bulls 3.39% (n=2) were diagnosed with posthitis. In goats, retention of placenta was 66.67% (n=6), abortion was 22.22% (n=2) and anestrous was 11.11% (n=1). There was one turkey with cloacal prolapse. All the animals having reproductive disease were treated in VTH. There was 93.22% improvement/effectiveness found in cows. The turkey and goats show 100% effectiveness of treatment. Conclusion: We can conclude that the most common reproductive diseases of cattle and goats in Bangladesh are uterine infection, anestrous, conception failure, pastular vulvo-vaginitis, vaginal prolapse, repeat breeding syndrome, abortion, retention of placenta and posthitis. Any disease or disorder of the genital tract may affect the reproduction as well as the production and fertility. Therefore, it is important to be concerned about the treatment and management of the diseases of the genital tract. Careful management and treatment of these diseases will ultimately help to increase the animal’s productivity in Bangladesh. The treatment given in VTH, BAU are successful for recovery.

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