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

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.

Author(s):  
Niina Humalajärvi ◽  
Pauliina Aukee ◽  
Matti V. Kairaluoma ◽  
Beata Stach-Lempinen ◽  
Harri Sintonen ◽  
...  

2019 ◽  
Vol 3 (1) ◽  

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.


2019 ◽  
Vol 87 (3) ◽  
pp. 130-136
Author(s):  
Mikhail Elikovich Enikeev ◽  
Dmitry Victorovich Enikeev ◽  
Dmitry Olegovich Korolev ◽  
Olesya Vyacheslavovna Snurnitsyna ◽  
Mikhail Vladimirovich Lobanov ◽  
...  

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.


Author(s):  
Shavkatov Hasan Shavkatovich ◽  
◽  
B.B. Negmadjanov ◽  

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.


2009 ◽  
Vol 15 (4) ◽  
pp. 211-216 ◽  
Author(s):  
Elizabeth A. Frankman ◽  
Jerry L. Lowder ◽  
Chiara Ghetti ◽  
Lara J. Burrows ◽  
Marijane A. Krohn ◽  
...  

Author(s):  
Sandra Rebouças Macêdo ◽  
José Ananias Vasconcelos Neto ◽  
José Tadeu Nunes Tamanini ◽  
Leonardo Bezerra ◽  
Rodrigo Aquino Castro

Abstract Objective To examine women with pelvic floor dysfunction (PFDs) and identify factors associated with sexual activity (SA) status that impacts quality of life (QoL). Methods We conducted a cross-sectional study that included women > 18 years old who presented with at least one PFD symptom (urinary incontinence [UI] and/or pelvic organ prolapse [POP]), in outpatient clinics specializing in urogynecology and PFD in Fortaleza, state of Ceará, Brazil, using a service evaluation form and QoL questionnaires. Results The analysis of 659 women with PFD included 286 SA (43.4%) women and 373 non-sexually active (NSA) (56.6%) women, with a mean age of 54.7 (±12) years old. The results revealed that age (odds ratio [OR] = 1.07, 95% confidence interval [CI] 1.03–1.12) and post-menopausal status (OR = 2.28, 95% CI 1.08–4.8) were negatively associated with SA. Being married (OR = 0.43, 95% CI 0.21–0.88) was associated with SA. Pelvic organ prolapse (OR = 1.16, 95% CI 0.81–1.68) and UI (OR = 0.17, 95% CI 0.08–0.36) did not prevent SA. SF-36 Health Survey results indicated that only the domain functional capacity was significantly worse in NSA women (p = 0.012). Two King's Health Questionnaire domains in NSA women, impact of UI (p = 0.005) and personal relationships (p < 0.001), were significantly associated factors. Data from the Prolapse Quality-of-life Questionnaire indicated that NSA women exhibited compromised QoL. Conclusion Postmenopausal status and age negatively affected SA. Being married facilitated SA. Presence of POP and UI did not affect SA. However, NSA women with POP exhibited compromised QoL.


Author(s):  
Surahman Hakim ◽  
Cut R Maharani

Objective: To determine changes in the quality of life in patients with pelvic organ prolapse who had undergone vaginal surgery. Methods: Prospective cohort study, carried out in Dr. Cipto Mangunkusumo and Fatmawati during the period of July 2015 to October 2016. The quality of life of the subjects was followed up three months after undergoing vaginal surgery. We used the Indonesian version of Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). Results: In this study, 25 subjects were involved. The results showed significant score reduction in the quality of life in patients treated with vaginal surgery with p < 0.05 in almost all scales except CRAIQ-7. Conclusion: There is a reduction in quality of life scores in patients treated with vaginal surgery at all scales except CRAIQ-7 with a value of p <0.05. [Indones J Obstet Gynecol 2017; 5-3: 164-167] Keywords: PFDI-20, PFIQ-7, POP, vaginal surgery


Impact ◽  
2020 ◽  
Vol 2020 (7) ◽  
pp. 19-21
Author(s):  
Katsuko Shinozaki

Urinary incontinence after childbirth, which is also referred to as postpartum urinary incontinence, is the involuntary leaking of urine that can be experienced by new mothers. It can also occur during pregnancy and, either way, can have a dramatic impact on quality of life. In addition to urinary incontinence, there are a range of other pelvic floor disorders that can affect pregnant women and new mothers, including pelvic organ prolapse and fecal incontinence. Katsuko Shinozaki is a researcher based at the Postgraduate School of Health and Welfare Science at the International University of Health and Welfare, Japan. She is focusing her research on this issue. Shinozaki is developing a programme for care during childbirth for the prevention of urinary incontinence.


2021 ◽  
pp. e20200053
Author(s):  
Corlia Brandt ◽  
E.C. Janse van Vuuren

Purpose: Postoperative physiotherapy in conjunction with pelvic organ prolapse (POP) surgery is still under-investigated and controversial. In this randomized controlled trial, pelvic floor muscle training (PFMT) and abdominal training were compared with a control condition (standard in-hospital treatment). Method: Eighty-one women were randomized to one of three groups. The Prolapse Quality of Life questionnaire, two-dimensional ultrasound, Pelvic Organ Prolapse Quantification System scale, the PERFECT (power, endurance, repetitions, fast contractions, every contraction timed) scheme, electromyography, Sahrmann scale, and pressure biofeedback unit (PBU) were used to measure quality of life (QOL), POP, and pelvic floor and abdominal muscle function. A mixed-model analysis of variance and the Kruskal–Wallis test was used for analysis. Results: Beneficial effects ( p < 0.05) were found for the PFMT group – increased power, number of fast contractions, amount of movement, endurance, and Sahrmann and PBU measures – compared with the control group. Abdominal training led to a significant ( p < 0.05) increase in bulging and discomfort, number of pelvic floor muscle contractions, and Sahrmann and PBU measures compared with the control condition; both groups showed significantly increased urinary frequency ( p < 0.05). Conclusions: Postoperative physiotherapy did not have a beneficial effect on QOL or POP symptoms. PFMT and abdominal training had beneficial effects on pelvic floor muscle function and abdominal muscle measures. Additional abdominal training led to increased symptoms.


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