scholarly journals Significant Improvement in Quality of Life, Positive Effect on Sexuality, Lasting Reconstructive Result and Low Rate of Complications Following Cystocele Correction Using a Lightweight, Large-Pore, Titanised Polypropylene Mesh

2019 ◽  
Vol 79 (09) ◽  
pp. 959-968 ◽  
Author(s):  
Tina Cadenbach-Blome ◽  
Markus Grebe ◽  
Mathias Mengel ◽  
Friedrich Pauli ◽  
Angelika Greser ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multicentre Study ◽  
Pelvic Floor ◽  
Polypropylene Mesh ◽  
Pelvic Organ ◽  
Wilcoxon Test ◽  
Pelvic Floor Reconstruction ◽  
Stable Reconstruction ◽  
Alloplastic Mesh

Abstract Introduction Patients who suffer from pelvic organ prolapse can experience severe limitations in their quality of life. To improve the quality of life of women affected and achieve a stable reconstruction, surgical therapy is often indispensable. In conventional prolapse surgery, the rate of recurrence is high. For this reason, alloplastic mesh has been implanted increasingly in recent years to reconstruct the anatomy of the pelvic floor organs. Even if the anatomical result can be significantly improved as a result, the mesh-induced complications have been the subject of controversial discussion. In this national, multicentre study, the quality of life, anatomical result as well as the rate of complications following the implantation of an alloplastic mesh for the correction of a cystocele were investigated. Method Fifty-four patients with symptomatic ≥ grade II were included in this prospective, national, multicentre study. The study participants were implanted with a titanised polypropylene mesh (TiLOOP® PRO A, pfm medical ag). The follow-up observation period was 12 months. Primary as well as repeat procedures were taken into account. The anatomic result of the pelvic floor reconstruction was quantified using the POP-Q system. Data on quality of life and sexuality were collected using validated questionnaires. All complications which occurred were documented and evaluated by an independent committee. Results On average, the patients were in line with the census. An improvement in quality of life was able to be determined during the study in all domains investigated (p < 0.001, Wilcoxon test). Minus incorrect entries and incorrect reports, a total of 19 reports of adverse events in 15 patients were evaluated by the end of the study. The rate of recurrence in the anterior compartment was 4.3%. Conclusion In the reconstruction of the anatomical position of the pelvic floor organs given the presence of a symptomatic cystocele, the implantation of a third-generation alloplastic mesh achieves very good results. Affected patients benefit from the anatomical stability as well as a significant improvement in quality of life, whereby the risks are justifiable.

scholarly journals Quality of Life, Sexuality, Anatomical Results and Side-effects of Implantation of an Alloplastic Mesh for Cystocele Correction at Follow-up after 36 Months

2017 ◽  
Vol 77 (09) ◽  
pp. 993-1001 ◽  
Author(s):  
Christian Fünfgeld ◽  
Margit Stehle ◽  
Brigit Henne ◽  
Jan Kaufhold ◽  
Dirk Watermann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Pelvic Floor ◽  
Wilcoxon Test ◽  
Clinical Event ◽  
System Quality ◽  
Surgical Meshes ◽  
The Impact ◽  
Alloplastic Mesh

Abstract Introduction Pelvic organ prolapse can significantly reduce quality of life of affected women, with many cases requiring corrective surgery. The rate of recurrence is relatively high after conventional prolapse surgery. In recent years, alloplastic meshes have increasingly been implanted to stabilize the pelvic floor, which has led to considerable improvement of anatomical results. But the potential for mesh-induced risks has led to a controversial discussion on the use of surgical meshes in urogynecology. The impact of cystocele correction and implantation of an alloplastic mesh on patientsʼ quality of life/sexuality and the long-term stability of this approach were investigated. Method In a large prospective multicenter study, 289 patients with symptomatic cystocele underwent surgery with implantation of a titanized polypropylene mesh (TiLOOP® Total 6, pfm medical ag) and followed up for 36 months. Both primary procedures and procedures for recurrence were included in the study. Anatomical outcomes were quantified using the POP-Q system. Quality of life including sexuality were assessed using the German version of the validated P-QoL questionnaire. All adverse events were assessed by an independent clinical event committee. Results Mean patient age was 67 ± 8 years. Quality of life improved significantly over the course of the study in all investigated areas, including sexuality and personal relationships (p < 0.001, Wilcoxon test). The number of adverse events which occurred in the period between 12 and 36 months after surgery was low, with just 22 events reported. The recurrence rate for the anterior compartment was 4.5%. Previous or concomitant hysterectomy increased the risk of recurrence in the posterior compartment 2.8-fold and increased the risk of erosion 2.25-fold. Conclusion Cystocele correction using a 2nd generation alloplastic mesh achieved good anatomical and functional results in cases requiring stabilization of the pelvic floor and in patients with recurrence. The rate of recurrence was low, the patientsʼ quality of life improved significantly, and the risks were acceptable.

scholarly journals Robotic sacrocolpopexy for the management of pelvic organ prolapse: quality of life outcomes

2019 ◽  
Vol 11 ◽  
pp. 175628721986859
Author(s):  
Annah Vollstedt ◽  
William Meeks ◽  
Veronica Triaca
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Clinical Improvement ◽  
Pelvic Organ ◽  
Robotic Sacrocolpopexy ◽  
Robotic Assisted ◽  
Rectocele Repair ◽  
Bowel Symptoms

Background: Our aim was to investigate longer-term surgical and quality of life (QOL) outcomes in a cohort of women undergoing robotic-assisted laparoscopic sacrocolpopexy (RALS) for pelvic organ prolapse (POP). Methods: We performed a retrospective cohort study at a single institution of female patients undergoing RALS with and without concomitant robotic-assisted laparoscopic hysterectomy, urethral sling, and rectocele repair. Scores from the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) surveys were used to evaluate QOL outcomes. Clinical improvement was defined by a decrease in a patient’s PFDI and PFIQ postoperative score by ⩾70%. Results: Clinical improvement was seen in 62.6% by the PFIQ and in 64% by the PFDI survey. Younger patient age (OR 0.92, p = 0.011) and worse preoperative American Urological Association (AUA) Quality of Life score (OR 1.42, p = 0.046) were associated with clinical improvement. Within the PFIQ, 35.6% of patients saw clinical improvement with their bowel symptoms, compared with bladder (54.1%, p < 0.001) and prolapse (45.6%, p = 0.053) symptoms. Within the PFDI, 45.5% of patients reached clinical improvement with their bowel symptoms, compared with bladder (56.7%, p = 0.035) and prolapse (62.6%, p < 0.001) symptoms. Of the patients who had a rectocele repair, 46.3% reached clinical improvement in their CRADI-8 score, and 51% saw clinical improvement in the bowel portion of the PDFI. Conclusions: Significantly fewer patients reached clinical improvement within the portions of the surveys that focus on bowel symptoms, compared with symptoms related to urination and POP. Of those that had a concomitant rectocele repair, approximately half reached clinical improvement with their bowel symptoms.

Quality of life and pelvic floor dysfunction symptoms after hysterectomy with or without pelvic organ prolapse

2014 ◽  
Vol 182 ◽  
pp. 16-21 ◽  
Author(s):  
Niina Humalajärvi ◽  
Pauliina Aukee ◽  
Matti V. Kairaluoma ◽  
Beata Stach-Lempinen ◽  
Harri Sintonen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ

scholarly journals Knowledge, Attitude and Practice of Physician toward Pelvic Floor Dysfunction KAP of Physician toward PFD

2019 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Pelvic floor dysfunction (PFD) as a term includes underlying different sub-conditions the major ones are pelvic organ prolapse (POP), urinary incontinence (UI), fecal incontinence (FI), sexual function. The direct effect of dysfunction in these areas can affect the quality of life on a personal and healthy level in patients with PFD.

scholarly journals Vaginal apical and anterior reconstruction using ultralight weight mesh: two-year follow-up

2018 ◽  
Vol 67 (3) ◽  
pp. 55-63
Author(s):  
Dmitry D. Shkarupa ◽  
Nikita D. Kubin ◽  
Eduard N. Popov ◽  
Ekaterina A. Shapovalova ◽  
Gleb V. Kovalev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
De Novo ◽  
Urine Volume ◽  
Operation Time ◽  
Pelvic Organ ◽  
Stage Ii ◽  
Apical Prolapse ◽  
Pelvic Floor Reconstruction

Introduction. Anterior and apical prolapse is the most common type of pelvic organ prolapse. The insufficient  effectiveness of native tissue repair in the pelvic organs leads to the search of new methods of the pelvic floor reconstruction. Objective. The current analysis was undertaken to evaluate the efficiency of the use of the Pelvix anterior mesh system (Lintex) with sacrospinous fixation of the apex in the treatment of anterior and apical prolapse. Methods. This study involved 150 women suffering from anterior-apical prolapse (stages III and IV). Reconstruction with the use of the mesh was performed in all the patients. To evaluate the results of surgical treatment, data of a vaginal examination (POP-Q), uroflowmetry, bladder ultrasound, and validated questionnaires (PFDI-20, PFIQ-7, PISQ-12) were used. All the listed parameters were determined before the surgery and on follow-up visits in 1, 6, 12, and 24 months after the treatment. Results. Mean operation time was 47 minutes. No cases of intraoperative clinically significant bleeding were reported. Anatomical cure rate (< stage II / asymptomatic stage II, according to the Baden-Walker system) at 12 months was found to be 94.4%, and at 24 months — 92.7%. Within the first month of follow-up, de novo stress urinary incontinence and de novo urgency occurred in 8.0% and 7.2% of patients, respectively. Statistically significant (p < 0.05) improvement in uroflowmetry parameters and decreased post-voiding urine volume were achieved after the surgery and did not change by 24 months. Comparison of the scores by the questionnaires revealed a significant improvement in the quality of life in the postoperative period. Conclusion. The use of the Pelvix anterior mesh system in the surgical correction of the anterior and apical prolapse is a safe uterus-sparing technique. At two-year follow-up, it provides a high anatomical efficiency, normalizes urodynamic parameters and improves quality of life.

Repair of cystocele and apical genital prolapse using 6-strap mesh implant

2019 ◽  
Vol 87 (3) ◽  
pp. 130-136
Author(s):  
Mikhail Elikovich Enikeev ◽  
Dmitry Victorovich Enikeev ◽  
Dmitry Olegovich Korolev ◽  
Olesya Vyacheslavovna Snurnitsyna ◽  
Mikhail Vladimirovich Lobanov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Organ ◽  
Stage Ii ◽  
Stage Iii ◽  
Pelvic Organ Prolapse Quantification ◽  
Genitourinary Prolapse ◽  
Mesh Implant

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.

scholarly journals Quality of life assessment in women after cervicosacropexy with polypropylene mesh for pelvic organ prolapse: a preliminary study

2015 ◽  
Vol 2 ◽  
pp. 126-129
Author(s):  
Wojciech Majkusiak ◽  
Edyta Horosz ◽  
Paweł Tomasik ◽  
Aneta Zwierzchowska ◽  
Mirosław Wielgoś ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Polypropylene Mesh ◽  
Pelvic Organ ◽  
Life Assessment ◽  
Quality Of Life Assessment ◽  
Preliminary Study

scholarly journals Optimization Of Pelvic Prolaps Surgical Correction Using Its Own Tissues

2020 ◽  
Vol 02 (12) ◽  
pp. 15-19
Author(s):  
Shavkatov Hasan Shavkatovich ◽  
◽  
B.B. Negmadjanov ◽  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Organ ◽  
Surgical Correction ◽  
World Data ◽  
Women Health ◽  
Health Initiative ◽  
Working Age

Pelvic organ prolapse (PTP) - pelvic floor and organ omission syndrome pelvic floor in isolation or in combination, which is extremely negatively affected by the quality of life of patients. According to world data, between 2.9 and 53% of women report some form of PTP. Up to 47% of pelvic organ prolapsed patients are women of working age. According to the Women Health Initiative Study, among 16,616 women of perimenopaus age, the incidence of uterine prolapsed was 14.2%, cystocele was 34.3%, and reconcile was 18.6%. In most cases, PTP is almost asymptomatic, which indicates its greater prevalence in the population.

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