scholarly journals Robotic-Assisted Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse: A Single Center Experience in China

2022 ◽  
Vol 2022 ◽  
pp. 1-5
Author(s):  
Ke Niu ◽  
Qingzhi Zhai ◽  
Wensheng Fan ◽  
Li’an Li ◽  
Wen Yang ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Life Quality ◽  
Operation Time ◽  
Pelvic Organ ◽  
Mesh Exposure ◽  
Robotic Assisted ◽  
Single Center Experience ◽  
Hospitalization Time ◽  
Mesh Excision

Objective. The aim is to investigate the efficiency and outcome of robotic-assisted sacrocolpopexy (RASC) in a cohort of patients with pelvic organ prolapse (POP) in our Gynecology Department. Methods. We performed a retrospective study of female patients who underwent RASC in Chinese PLA General Hospital from January 2013 to December 2020. Their clinical features included age, degree of prolapse, menopause time, body mass index, pregnancy, delivery, operation time, and bleeding volume. All patients were followed up for more than 6 months. POP-Q was recorded to evaluate the position of prolapsed organs. PFDI-20, PFIQ-7, and PGI-I were used to evaluate the life quality after surgery. Results. Twenty-four patients with POP received RASC in our center. The intraoperative bleeding was 86.9 ± 98.3 ml (20–300 ml). The operation time was 143.5 ± 47.3 min (60–240 minutes). The hospitalization time was 10.4 ± 2.1 days (8–16 days). And the follow-up time was 40.8 ± 22.0 months (6–72 months). In the POP-Q follow-up, postoperative Aa, Ba, Ap, Bp, and C were significantly improved than those before surgery ( P < 0.05 ). The objective and subjective cure rate was 100%. PGI-I score was very good in 9 (9/24), very good in 10 (10/24), and good in 3 (3/24). Postoperative PFDI-20 and PFIQ-7 were 2.78 ± 3.82 and 1.57 ± 3.86, which decreased dramatically after surgery ( P < 0.05 ). Mesh exposure occurred in 4 cases (16.7%) at 2–12 months. The exposed diameters were less than 1 cm in 3 cases (2 A/T3/S1) and 1-2 cm in 1 case (3 B/T3/S1). These mesh exposures healed after conservative observation or mesh excision. Conclusion. RASC for POP has the advantage of less bleeding and hospitalization time. It is a minimally invasive option for pelvic organ prolapse.

Long-term observation on postoperative recurrence and complications of transvaginal mesh surgery for pelvic organ prolapse

2021 ◽  
Author(s):  
Junfang Yang ◽  
Kun Zhang ◽  
Jinsong Han ◽  
Yiting Wang ◽  
Ying Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Protective Factor ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Transvaginal Mesh ◽  
Mesh Exposure ◽  
Mesh Surgery ◽  
Post Menopause

Objective: This study aims to evaluate the risk factors for subjective recurrence and complications of patients who underwent transvaginal synthetic mesh surgery. Design：This retrospective cohort study included patients who received transvaginal mesh (TVM) surgery between January 2005 and June 2019. Methods: The information of patients was collected, including basic characteristics, subjective recurrence, and mesh-related complications. The clinical characteristics of patients with and without subjective recurrence were compared. The sexual activities of patients before and after the operation were recorded. SPSS 20.0 was used for the statistical analysis. Results: A total of 257 patients were included. Among them, 62 (24.1%) patients were lost to follow-up. The median follow-up time was 80 months (12 months, 170 months). Finally, 195 patients were followed up, 11 (5.6%) patients had a subjective recurrence of pelvic organ prolapse, and 26 (13.3%) patients had mesh-related complications (11 patients with de novo pain and 15 patients with mesh exposure). We found significant differences in age (68.9±5.1 vs. 63.4±5.8 years old), years of post-menopause (17.5±6.3 vs. 13.3±6.9 years), previous hysterectomy (27.3% vs. 6.0%), and concomitant hysterectomy (45.5% vs. 81.0%) between patients with and without subjective recurrence (P<0.05). The mesh exposure proportion of patients with total vaginal mesh (47.6%) was significantly higher than that with anterior vaginal mesh (2.9%) (P<0.05). Furthermore, 6.7% of sexually active patients reported do novo dyspareunia. Limitation: The investigators could only record the subjective recurrence of patients, thus there is a lack of objective recurrence data. Conclusion: Age, years of post-menopause and previous hysterectomy are risk factors for subjective recurrence of transvaginal mesh surgery; however，concomitant hysterectomy is a protective factor. Mesh exposure is the most common complication, especially for total vaginal mesh repair surgery.

Tension-free vaginal mesh procedure for pelvic organ prolapse: A single-center experience of 310 cases with 1-year follow up

2010 ◽  
Vol 17 (4) ◽  
pp. 353-358 ◽  
Author(s):  
Satoru Takahashi ◽  
Daisuke Obinata ◽  
Takahiro Sakuma ◽  
Yusuke Nagane ◽  
Katsuhiko Sato ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Single Center ◽  
Tension Free ◽  
Single Center Experience

scholarly journals Safety and Effectiveness of Transvaginal Mesh Placement in Treating Pelvic Organ Prolapse

2019 ◽  
Author(s):  
Zeyu Chen ◽  
Wensheng Du ◽  
Haitao Zhu
Keyword(s):  
Pelvic Organ Prolapse ◽  
Blood Loss ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Operation Time ◽  
Pelvic Organ ◽  
Transvaginal Mesh ◽  
Mesh Exposure ◽  
Intraoperative Blood Loss ◽  
Postoperative Fever

Abstract To observe the clinical effect and complications of transvaginal mesh (TVM) placement on treating pelvic organ prolapse (POP).Methods From May 2014 to June 2017, 89 patients with moderate to severe pelvic organ prolapse and pelvic floor defect (PFD) had received TVM pelvic reconstruction at our hospital. The operation time, intraoperative blood loss and intraoperative complications of all patients were recorded, and the incidence of postoperative complications was also observed. In addition, the POP-Q was utilized to evaluate the severity of POP in patients before surgery, as well as at 6 weeks, 6 months, 12 months and 24 months after surgery, respectively; besides, the Pelvic Floor Influence Questionnaire-7 (PFIQ-7), Pelvic Floor Dysfunction Inventory 20 (PFDI-20), and Patient Global Impression of Improvement (PGI-I) were adopted to evaluate the quality of life of patients.Results All the 89 cases had successfully completed the surgery, with the operation time of 60.0±13.0 min and the intraoperative blood loss of 57.2±21.9 mL. All patients had no bladder or rectal injury during the surgery. 2 patients displayed asymptomatic recurrence ,10 cases had postoperative fever, while 3 had mesh exposure, and all of them were improved after symptomatic treatment. Upon discharge, the lumbosacral and pubic discomfort, as well as pelvic organ dragging sensation had disappeared in all patients. In the final follow-up, the PFIQ-7 and PFDI-20 scores in the 89 cases were reduced compared with those before surgery (Ps<0.05).Conclusions TVM placement is effective on treating moderate to severe POP, which is associated with a lower complication rate and higher postoperative satisfaction.

scholarly journals Outcome of Colpoclesis in Advanced Pelvic Organ Prolapse in Elderly Women

2019 ◽  
Vol 47 (2) ◽  
pp. 17-22
Author(s):  
Rehana Pervin ◽  
AKM Sadiqul Azam ◽  
Kazi Shafiqul Halim ◽  
Syed Monirul Islam ◽  
Nazma Khalil ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Elderly Women ◽  
Operation Time ◽  
Pelvic Organ ◽  
P Value ◽  
Urinary Flow ◽  
Subjective Outcome ◽  
Residual Urine ◽  
Advanced Pelvic Organ Prolapse

To find out the safety, effectiveness and outcome of colpocleisis in advanced pelvic organ prolapse in elderly women. A prospective study was conducted in Sheikh Hasina Medical College,Tangail (250 beded general hospital,tangail) among 75 female patients aged 60 years and above with diagnosed cases of Pelvic Organ Prolapse (POP) during the period from February 2014 to February 2018 who had no desire in coital function. Patient information were recorded pre-operative, per-operative and post-operative period. Urodynamic investigation (uroflometry and post void residual urine) were done during pre-operative  and early postoperative period. Follow up was done at 6 week, 3 month and then annually. Main outcome measures were relieving symptoms, recurrence of prolapse and development of urinary incontinence. Patient satisfaction (Subjective outcome) measured by interview during follow up. Colpocleisis was performed in 75 patients. Mean (age of the patients was 66.69 SD ±5.9 years, mean BMI 18.12 SD ±1.69 kg/m2 and mean parity 5.56 SD ±1.9. Majority of operation done under saddle block, only 21.31% was done under local anaesthesia. Mean operation time was 36.16 SD±6.23 minutes, mean blood loss was 41.61 SD±8.34 ml and mean hospital stay was 2.24 SD ±0.49 days. Objective and subjective outcome were same 98.7% only 1.3% patient developed recurrent prolapse (Failed operation) and 1.3% patient developed urinary urge incontinence. The mean differences were significant for the pre and postoperative maximum urinary flow rate, voided volume, post void residual urine (P value is 0.001). Colpocleisis is safe, effective with high success rate in the management of advance pelvic organ prolapse, who do not wish to preserve coital function. So it can be considered as one of surgical option for treating advance pelvic organ prolapse. Bangladesh Med J. 2018 May; 47 (2): 17-22

Pelvic Organ Prolapse Repair with Mesh: Description of Surgical Technique Using the Surelift® Anterior Repair System

2020 ◽  
pp. 1-6
Author(s):  
Laura Mateu-Arrom ◽  
Cristina Gutiérrez-Ruiz ◽  
Joan Palou Redorta ◽  
Carlos Errando-Smet
Keyword(s):  
Pelvic Organ Prolapse ◽  
Surgical Technique ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Repair System ◽  
Mesh Exposure ◽  
Anterior Repair ◽  
Preliminary Results ◽  
Pop Repair

<b><i>Introduction:</i></b> Although the use of transvaginal mesh (TVM) in the repair of pelvic organ prolapse (POP) has been restricted, there are still some cases in which TVM may be the most appropriate approach. The TVM Surelift® anterior repair surgical technique has not been described previously. <b><i>Objective:</i></b> The aim of this study was to describe the surgical technique and to report our preliminary results regarding efficacy and complications. <b><i>Methods:</i></b> A step-by-step description of surgical technique is presented. A descriptive retrospective analysis was performed to evaluate our preliminary results in 17 women who underwent POP repair using the Surelift® anterior repair system in our department between 2014 and 2017. TVM was offered to patients with symptomatic apical (primary or recurrent) or recurrent anterior POP stage ≥2. POP recurrence was classified as asymptomatic anatomic or symptomatic. Patients rated satisfaction with surgery on a scale from 0 to 10. Complications during follow-up were classified according to the International Urogynecological Association/International Continence Society recommendations. <b><i>Results:</i></b> Median (IQR) follow-up was 19.9 months (24.8). Two (11.8%) anatomic recurrences were identified, both symptomatic, but neither required further surgery. No cases of pelvic pain, dyspareunia, voiding, or defecatory dysfunction were detected. Two (11.8%) patients presented a &#x3c;1-cm vaginal mesh exposure (2AaT3S2) requiring partial mesh removal through a vaginal approach. At the end of follow-up, median satisfaction (IQR) with the surgery was 9 (3.1). <b><i>Conclusion:</i></b> The Surelift® anterior repair system is effective in correcting apical or recurrent anterior POP, with a high patient satisfaction rate. Complications after this surgery are infrequent and are mostly related to vaginal mesh exposure.

scholarly journals The Learning Curve in Vaginal Pelvic Reconstruction Surgery for Severe Pelvic Organ Prolapse: Analysis of the Cumulative Summation Test (CUSUM)

2021 ◽  
Author(s):  
Chin-Jui Wu ◽  
Kuan-Ju Huang ◽  
Wen-Chun Chang ◽  
Ying-Xuan Li ◽  
Lin-Hung Wei ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Learning Curve ◽  
Reconstructive Surgery ◽  
Operation Time ◽  
Pelvic Organ ◽  
Pelvic Reconstructive Surgery ◽  
Surgical Success ◽  
Advanced Pelvic Organ Prolapse ◽  
Cumulative Summation

Abstract Women who underwent vaginal pelvic reconstructive surgery with or without mesh consecutively between 2004 and 2018 were retrospectively analyzed to determine the learning curve in vaginal pelvic reconstructive surgery. With cumulative summation (CUSUM) analysis of surgical failure and operation time, we assessed the learning curve of vaginal pelvic reconstructive surgery, including sacrospinous ligament fixation, anterior colporrhaphy, posterior colporrhaphy, and optional vaginal hysterectomy with or without mesh placement. Two hundred and sixty-four women with stage III or IV pelvic organ prolapse underwent vaginal pelvic reconstructive surgery by surgeon A or B. The median follow-up time of 44 months ranged from 24 to 120 months. Surgical proficiency was achieved in 32-54 vaginal pelvic reconstructive surgery procedures without mesh and 37-61 procedures in the same surgery with mesh. The surgical success rates for surgeons A and B were 82.2% and 94.1%, with median follow-up times of 60 and 33 months, respectively. The learning phase of vaginal pelvic reconstructive surgery in advanced pelvic organ prolapse in this institutional cohort required 54 and 61 procedures, respectively. A higher number of procedures were required for the learning curve of vaginal pelvic reconstructive surgery with mesh. Having crossed the boundary of proficiency, the surgical success rate and operation time were improved.

scholarly journals Pelvic organ prolapse surgery and health-related quality of life: a follow-up study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tadesse Belayneh ◽  
Abebaw Gebeyehu ◽  
Mulat Adefris ◽  
Guri Rortveit ◽  
Janne Lillelid Gjerde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Prolapse Surgery ◽  
Stage Iii ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background Symptomatic prolapse impairs quality of life. Health-related quality of life (HRQoL) is considered an important outcome of pelvic organ prolapse (POP) surgery. However, it is rarely reported, and measures are inadequately used. Thus, studies reporting patient-reported surgical outcomes in low-income contexts are needed. This study aims to evaluate the effect of prolapse surgery on patient HRQoL and determine the predictive factors for change in HRQoL. Methods A total of 215 patients who had prolapse stage III or IV were enrolled. Patients underwent vaginal native tissue repair, and their HRQoL was evaluated at baseline, 3 and 6 months postoperatively. Effect of surgery on subjective outcomes were measured using validated Prolapse Quality of Life (P-QoL-20), Prolapse Symptom Score (POP-SS), Body Image in Prolapse (BIPOP), Patient Health Questionnaire (PHQ-9), and Patient Global Index of Improvement (PGI-I) tools. A linear mixed-effect model was used to compare pre- and postoperative P-QoL scores and investigate potential predictors of the changes in P-QoL scores. Results In total, 193 (89.7%) patients were eligible for analysis at 3 months, and 185 (86.0%) at 6 months. Participant’s mean age was 49.3 ± 9.4 years. The majority of patients had prolapse stage III (81.9%) and underwent vaginal hysterectomy (55.3%). All domains of P-QoL improved significantly after surgery. Altogether more than 72% of patients reported clinically meaningful improvement in condition-specific quality of life measured with P-QoL-20 at 6 months. An improvement in POP-SS, BIPOP, and the PHQ-9 scores were also observed during both follow-up assessments. At 6 months after surgery, only 2.7% of patients reported the presence of bulge symptoms. A total of 97.8% of patients had reported improvement in comparison to the preoperative state, according to PGI-I. The change in P-QoL score after surgery was associated with the change in POP-SS, PHQ, BIPOP scores and marital status (p < 0.001). However, age, type of surgery, and prolapse stage were not associated with the improvement of P-QoL scores. Conclusions Surgical repair for prolapse effectively improves patient’s HRQoL, and patient satisfaction is high. The result could be useful for patient counselling on the expected HRQoL outcomes of surgical treatment. Surgical service should be accessible for patients suffering from POP to improve HRQoL.

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