Anatomical Outcome After Sacrospinous Fixation Procedure on Pelvic Organ Prolapse Cases in Cipto Mangunkusumo Hospital Year 2013–2018

2020 ◽  
Vol 36 (5) ◽  
pp. 250-256
Author(s):  
Alfa P. Meutia ◽  
Adia Triyarintana
2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Zelalem Mengistu ◽  
Mezigebu Molla

Abstract Introduction Genitourinary tract trauma caused by ox horn injury in the presence of pelvic organ prolapse (POP) is an extremely rare phenomenon and associated with devastating morbidity. Case presentation A 50-year-old multiparous postmenopausal woman from rural northwest Ethiopia presented with the primary complaint of urinary incontinence 6 days after she suffered ox horn injury to her prolapsed genitalia. She had stage 3 pelvic organ prolapse with the leading point being the cervix. The anterior vaginal and posterior bladder walls were disrupted with visible draining of the left ureter. The wound was dirty and edematous with whitish discharge. She was admitted to the urogynecology ward and provided with wound care until the infection subsided. Apical prolapse suspension was performed using right sacrospinous fixation, and bladder repair was carried out 6 weeks following the prolapse suspension. She recovered well and was continent when discharged. Conclusion Ox horn injury involving the female lower urogenital tract in the presence of POP is extremely rare. Late presentation after sustaining injury is associated with increased risk of morbidity and long hospital stay, and treatment requires multistage surgery.


Author(s):  
Anuja V. Bhalerao ◽  
Vaidehi Ajay Duddalwar

Background: Pelvic organ prolapse (POP) is the descent of the pelvic organs beyond their anatomical confines. The definitive treatment of symptomatic prolapse is surgery but its management in young is unique due to various considerations. Aim of this study was to evaluate anatomical and functional outcome after abdominal sacrohysteropexy and vaginal hysterectomy for pelvic organ prolapse in young women.Methods: A total 27 women less than 35 years of age with pelvic organ prolapse underwent either abdominal sacrohysteropexy or vaginal hysterectomy with repair. In all women, pre-op and post-op POP-Q was done for evaluation of anatomical defect and a validated questionnaire was given for subjective outcome.Results: Anatomical outcome was significant in both groups as per POP-Q grading but the symptomatic outcome was better for sacrohysteropexy with regard to surgical time, bleeding, ovarian conservation, urinary symptoms, sexual function.Conclusions: Sacrohysteropexy is a better option.


Author(s):  
Elisia Elisia ◽  
Tyas Priyatini

Abstract Objective: To determine the incidence of post-operative urinary retention after pelvic organ prolapse reconstruction and associated factors. Method: This was a prospective cohort study conducted in Dr. Cipto Mangunkusumo and another associate hospital. We recruited women planned for pelvic organ prolapse reconstruction from April 2013 to April 2015. Inclusion and exclusion criteria were women with pelvic organ prolapse (2nd, 3rd and 4th degree) without prior urinary retention, drugs affecting bladder function, and history of bladder injury. After surgery, urinary catheter was applied for 24 hours. Six hours apart from urinary catheter released, residual urine was measured. Urinary retention was defined as residual urine more than 100 ml. Result: Of 200 subjects, 59 of them (29.5%) classified as having urinary retention. No association found between age, body mass index (BMI), degree of prolapse, degree of cystocele and urinary tract infection toward urinary retention. Total vagina hysterectomy + anterior colporaphy + colpoperineoraphy + sacrospinous fixation and reconstruction duration more than 130 minutes were associated with urinary retention (relative risk (RR) 3.66; 95% CI 2.91-4.60; p


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Salvatore Giovanni Vitale ◽  
Antonio Simone Laganà ◽  
Marco Noventa ◽  
Pierluigi Giampaolino ◽  
Brunella Zizolfi ◽  
...  

Objective. Our aim was to study the efficacy of transvaginal bilateral sacrospinous fixation (TBSF) and its impact on quality of life (QoL) and sexual functions in women affected by second recurrences of vaginal vault prolapse (VVP). Materials and Methods. We performed a prospective observational study on 20 sexually active patients affected by second recurrence of VVP, previously treated with monolateral sacrospinous fixation. TBSF was performed in all the patients. They had been evaluated before the surgery and at 12-month follow-up through pelvic organ prolapse quantification (POP-Q) system, Short Form-36 (SF-36), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Results. At 12-month follow-up, 18 out of 20 (90%) patients were cured of their recurrent VVP. No major intra- and postoperative complications occurred. We found a significant improvement in 4/5 POP-Q landmarks (excluding total vaginal length), SF-36, and PISQ-12 scores. Conclusion. According to our data analysis, TBSF appears to be safe, effective, and able to improve both QoL and sexual functions in patients affected by second recurrence of VVP after previous monolateral sacrospinous fixation.


2018 ◽  
Vol 16 (3) ◽  
pp. 321-324 ◽  
Author(s):  
Ganesh Dangal ◽  
Rekha Poudel ◽  
Ranjana Shrestha ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
...  

Background: Pelvic organ prolapse includes descent of anterior/ posterior wall and apical (vault) prolapse with significant morbidity. In this study we evaluated the outcome of sacrospinous ligament fixation of vault through vaginal approach as part of the repair for massive uterovaginal (pelvic organ prolapse stage III and stage IV) and vault prolapse. Methods: This study on sacrospinous ligament fixation along with repair for pelvic organ prolapse at Kathmandu Model Hospital from November 2016 to April 2018 was done to assess the outcome in terms of early (during hospital stay) and delayed (six months) post-operative complications, need of removal of sacrospinous fixation suture and recurrence of prolapse. Results: Out of 95 pelvic organ prolapse patients, 80 (84%) were post-menopausal, 28 (29.4%) were in the age group of 70-79 years.  There were 61 (64%) POPQ stage III. The post-operative complications during post-operative hospital stay were pain over right buttock in 42 (44%), urinary retention in 7 (7%) and UTI in 7 (7%). Sacrospinous suture was released in two patients for severe pain over right buttock.  At one-week follow-up, 35 (36%) had right buttock pain of moderate severity and 8 (8%) had vaginal cuff infection. Sacrospinous suture was removed in one patient for neuropraxia two weeks following surgery. At four weeks follow-up, 25 (26%) patients had mild right buttock pain relieved by oral NSAIDs on need. At six months follow-up, five had occasional buttock pain, six had some recurrences and two had some vault prolapse and one each had short vagina and stress incontinence. Conclusions: Sacrospinous   ligament   fixation   is   a   good   procedure   for   the management of pelvic organ prolapse with better long-term outcome if performed with good surgical expertise. Keywords:  Prolapse; repair; sacrospinous fixation; vaginal hysterectomy. 


2020 ◽  
Author(s):  
Peter Urdzík ◽  
Vladimir Kalis ◽  
Mija Blaganje ◽  
Zdenek Rusavy ◽  
Martin Smazinka ◽  
...  

Abstract Backround: The aim of this study was to explore the personal views of female gynecologists regarding the management of POP with a particular focus on the issue of uterine sparing surgery. Methods: A questionnaire based survey of practicing female gynaecologists in the Czech Republic, Slovenia and Slovakia. Results : A total of 140 female gynaecologists from 81 units responded to our questionnaire. The majority of respondents stated they would rely on a urogynecologist to aid them with their choice of POP management options. The most preferred options for POP management were sacrocolpopexy and physiotherapy. Almost 2/3 of respondents opted for a hysterectomy together with POP surgery, if they were menopausal, even if the anatomical outcome was similar to uterine sparing POP surgery. Moreover, 81.4% of respondents, who initially opted for a uterine sparing procedure, changed their mind if the anatomical success of POP surgery with concomitant hysterectomy was superior. Discussing uterine cancer risk in relation to other organs had a less significant impact on their choices. Conclusions: The majority of female gynecologists in our study opted for hysterectomy if they were postmenopausal at the time of POP surgery. However, variation in information provision had an impact on their choice.


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