scholarly journals Modified technique for sacrospinous-sacrotuberous ligament complex colpopexy in apical prolapse: preliminary results of a pilot randomized study

2020 ◽  
Vol 9 (12) ◽  
pp. 4785
Author(s):  
Mohamed S. Sweed ◽  
Hassan A. Mostafa ◽  
Hazem M. Sammour ◽  
Hisham A. Ashour ◽  
Mahmoud A. Nadim ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Randomized Study ◽  
Group Versus ◽  
Pelvic Organ ◽  
Conventional Technique ◽  
Base Line ◽  
Apical Prolapse ◽  
Modified Technique ◽  
Sacrotuberous Ligament ◽  
Mesh Augmentation

Background: Apical prolapse is frequently encountered following vaginal hysterectomy either or as a primary finding in patients with pelvic organ prolapse. This pilot comparative study introduces a modified sacrospinous sacrotuberous ligament fixation with biologic mesh augmentation which necessitates no special kits to be performed.Methods: This study was conducted at Department of Obstetrics and gynecology, Ain Shams University, Cairo, Egypt, and Department of Women Health of Bethanien Hospital, Iserlöhn, Germany from March 2018 to May 2020. 40 women with either utero-vaginal or vaginal vault prolapse were randomized to either; group (A): 20 women scheduled for modified sacrospinous-sacrotuberous fixation procedure, or group (B): 20 women scheduled for conventional sacrospinous-sacrotuberous fixation procedure.Results: Improvement of the Pelvic organ prolapse quantification system (POP-Q) stage from the base line pre-operative stage was 1 stage higher in the modified SS/ST-F group compared to the conventional SSF group (3 stage improvement from baseline in SS/ST-F group versus 2 stage improvement only in conventional SSF group).Conclusions: This pilot study provides a modified sacrospinous sacrotuberous ligament colpopexy technique which is easier to be performed and mastered, does not need the use of special devices, provides better improvement of grade of prolapse and less complications compared to the conventional technique. 

scholarly journals Iatrogenic endometriosis following apical pelvic organ prolapse surgery: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Alkan Cubuk ◽  
Orkunt Ozkaptan ◽  
Jörg Neymeyer
Keyword(s):  
Case Report ◽  
Pelvic Organ Prolapse ◽  
De Novo ◽  
Pelvic Organ ◽  
Prolapse Surgery ◽  
Uterine Disease ◽  
Apical Prolapse ◽  
Sacral Promontory ◽  
Laparoscopic Supracervical Hysterectomy ◽  
Supracervical Hysterectomy

Abstract Background Iatrogenic endometriosis is the presence of endometrial glands and stroma out of the uterus following certain surgical interventions. The rate of iatrogenic endometriosis after gynecologic surgeries due to benign uterine disease is 1–2%. Laparoscopic supracervical hysterectomy is also a part of frequently used surgical treatment of apical pelvic organ prolapse, which is followed by sacrocervicopexy. However, there are no data about iatrogenic endometriosis after apical prolapse surgery in the current literature. Herein, we present a case report of a patient diagnosed with de novo endometriosis 1 year after laparoscopic supracervical hysterectomy and sacrocervicopexy. Case presentation A 46-year-old parous Slavic woman who underwent laparoscopic supracervical hysterectomy and sacrocervicopexy secondary to grade 3 symptomatic apical prolapse 1 year earlier was admitted to the same clinic with pelvic pain that had started 6 months following surgery. Deep vaginal palpation was painful. Transvaginal ultrasonography revealed an area with hypervascularization on the sacral promontory. She was scheduled for diagnostic laparoscopy. A 2 × 2-cm solid, wine-colored, hypervascular hemorrhagic lesion was seen on the sacral promontory. The lesion and the peritoneal layer behind it were totally excised. The patient was discharged on the first postoperative day, without any complications. Pathologic examination revealed foci of endometriosis comprising endometrial glands and stroma within the connective tissue, along with hemosiderin-laden macrophages. The symptoms of the patient resolved after the surgery, and no further adjuvant treatment was needed. Conclusion Although the rate of iatrogenic endometriosis is low after laparoscopic supracervical hysterectomy and sacrocervicopexy, the possibility of the occurrence of iatrogenic endometriosis should be discussed with patients who are diagnosed with apical prolapse to determine the type of surgical intervention. Iatrogenic endometriosis should be kept in mind for differential diagnosis in case of pain after laparoscopic supracervical hysterectomy and sacrocervicopexy.

scholarly journals Surgical Options for Apical Prolapse Repair

2012 ◽  
Vol 8 (5) ◽  
pp. 557-566
Author(s):  
Ngoc-Bich Le ◽  
Lisa Rogo-Gupta ◽  
Shlomo Raz
Keyword(s):  
Pelvic Organ Prolapse ◽  
Primary Care Physicians ◽  
Medical Condition ◽  
Pelvic Organ ◽  
Medical Community ◽  
Apical Prolapse ◽  
Prolapse Repair ◽  
Common Medical Condition ◽  
The Usa ◽  
Surgical Options

Pelvic organ prolapse is a common medical condition that affects the quality of life of many women. Approximately 50% of parous women have pelvic organ prolapse and the lifetime risk for surgical intervention is 6.7% at the age of 80 years. In the USA, the number of women at risk for symptomatic prolapse is increasing, which is consistent with the recent increase in the overall number of prolapse and incontinence procedures being performed. Although prolapse is usually multicompartmental and isolated defects are rare, the apical compartment deserves special attention because apical support is integral to a durable prolapse repair. Since many women may initially present to their primary care physicians, all members of the medical community should have a basic understanding of the diagnosis and treatment for apical prolapse.

Pelvic Organ Prolapse Suspension Introducing a Modified Technique: Technical Description and Report of 92 Cases

2016 ◽  
Vol 223 (4) ◽  
pp. e87
Author(s):  
Giammauro Berardi ◽  
Federico Tomassini ◽  
Fioralba Pindozzi ◽  
Massimo Pezzatini ◽  
Anna Dall'Oglio ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Modified Technique ◽  
Technical Description

Pelvic organ prolapse recurrence after apical prolapse repair: does obesity matter?

2021 ◽  
Author(s):  
Nina Durchfort Metcalfe ◽  
Lisa M. Shandley ◽  
Marisa Rogers Young ◽  
Michelle Higgins ◽  
Chidimma Abanulo ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Apical Prolapse ◽  
Prolapse Repair ◽  
Prolapse Recurrence

Synthetic Mesh Used in Gynecologic Reconstructive Surgery for Pelvic Floor Disorders

2017 ◽  
Vol 752 ◽  
pp. 59-63
Author(s):  
Elvira Brătilă ◽  
Petre Brătilă ◽  
Diana Comandașu ◽  
Monica Cîrstoiu ◽  
Roxana Bohîlțea ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Pelvic Organ ◽  
Synthetic Mesh ◽  
Effective Porosity ◽  
Apical Prolapse ◽  
Mesh Surgery

Pelvic floor disorders including stress urinary incontinence and pelvic organ prolapse represent a challenge for gynecologist or urogynecologist even nowadays. Conservative treatment for these conditions proves its effectiveness only in few cases selected from early forms of incontinence or prolapse the most cases being solved surgically. The introduction of the procedure imagined by Petros and Ulmsten, known as TVT (Trans Vaginal Tape) in which the medium urethra is supported by a synthetic tape produced in 1996 a revolution in the surgical treatment of stress urinary incontinence. Radical changes also appeared in pelvic organ prolapse surgery extrapolating the hernia repair procedure by using synthetic mesh. After nearly 20 years of experience the mesh surgery is today a common practice in urogynecology. Between 2011 and 2015 we operated in private practice a total number of 297 cases of which 187 cases of stress urinary incontinence and 110 cases of pelvic organ prolapse. From these 86 (78,1%) cases were represented by cystoceles, associated with early apical prolapse or rectoceles, 18 (16,3%) cases by apical prolapse (grade III-IV) and 6 (5,4%) cases by posterior compartment prolapse alone. We performed mesh surgery in 32 (29%) cases represented mainly by anterior compartment prolapse. In 6 (18,7%) cases we founded mesh extrusion which required partially resection. In two cases we performed large resection of anterior vaginal wall required grafting with acellular second generation graft. In all cases with mesh extrusion the biomechanical analysis revealed significant decrease in effective porosity of the mesh due to excessive tensioning or folding of the mesh. The use of mesh in stress urinary incontinence and pelvic organ prolapse represent a justified alternative in selected cases. The specific complications due to meshes are more frequent in prolapse surgery compared to stress urinary incontinence. In all cases altered effective porosity due to technical defects in surgery represents the leading cause.

scholarly journals Adaptation of Pelvic Organ Prolapse Guideline in Iranian Adult Women

2018 ◽  
Vol 6 (1) ◽  
pp. 6
Author(s):  
Parvin Bastani ◽  
Fateme Mallah ◽  
Leili Rasouli Fard
Keyword(s):  
Pelvic Organ Prolapse ◽  
Treatment Process ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Common Disease ◽  
Adult Women ◽  
Apical Prolapse ◽  
Posterior Vaginal Wall Prolapse ◽  
Diagnosis Method ◽  
Social And Cultural Factors

Pelvic organ prolapse (POP) is a common disease which present as symptomatic descent of the anterior or posterior vaginal wall prolapse, uterus or apical prolapse subsequent to hysterectomy, and entrocele. Since, social and cultural factors have impact on interval between symptoms incidence and seek for medical care, diagnosis method and treatment process, it was important to prepare a guideline for management of the Iranian women with POP.

Sign in / Sign up

Export Citation Format

Share Document