scholarly journals Effect of traditional versus site specific anterior repair in reduction of urinary symptoms in women with pelvic organ prolapse

2021 ◽  
Vol 8 (4) ◽  
pp. 507-512
Author(s):  
Aditi Sawant ◽  
Anuja Bhalerao ◽  
Kritika Bhalerao
Keyword(s):  
Pelvic Organ Prolapse ◽  
Vaginal Hysterectomy ◽  
Age Groups ◽  
Pelvic Organ ◽  
Assessment Method ◽  
Urinary Symptoms ◽  
Functional Improvement ◽  
Anterior Repair ◽  
Site Specific ◽  
Repair Group

The present study was undertaken to evaluate effect of traditional anterior repair versus site specific anterior repair in reduction of urinary symptoms in women with Pelvic organ Prolapse. During the study period of 2 years 140 women belonging to reproductive, peri-menopausal and postmenopausal age groups were included in the study. Employing past literature, the sample size calculated was 140. All women were assessed pre-operatively by the assessment method – Pelvic organ prolapse quantification (POP-Q) system. 70 women belonging to Group A were treated according to vaginal hysterectomy with traditional anterior repair and 70 women belonged to Group B who were treated according to vaginal hysterectomy with site specific anterior repair.Post-operatively, all women were followed up till 7th post-operative day and were assessed for anatomical and functional improvement to determine a better method for repair in reduction of urinary symptoms in women with pelvic organ prolapse.Our study shows functional and anatomical outcomes of traditional anterior repair and site specific anterior repair. 48 of 70 women (68.2%) who were subjected to traditional anterior repair and 52 of 70 women (73.4%) who were subjected to site specific anterior repair had marked functional improvement after surgery. 58 of 70 women (83.2%) belonging to traditional anterior repair group and 67 of 70women (95.3%) belonging to Site specific anterior repair group had considerable anatomical improvement post-operatively. This impresses the role of site specific anterior repair in women with pelvic organ prolapse for attaining better functional and anatomical outcome.

scholarly journals Assessment of Pelvic Organ Prolapse by Pelvic Organ Prolapse Quantification Technique Among Pre-operative Patients

2014 ◽  
Vol 8 (2) ◽  
pp. 26-29
Author(s):  
T Pradhan ◽  
MC Regmi ◽  
R Rai ◽  
R Bhatta ◽  
P Rijal ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Anterior Segment ◽  
Pelvic Organ ◽  
Urinary Symptoms ◽  
Pelvic Organ Prolapse Quantification ◽  
Urinary Frequency ◽  
Site Specific ◽  
Obstetrics And Gynaecology ◽  
Stage 4 ◽  
One Year

Aims: This was performed to examine pelvic organ prolapse using POP-Q technique and correlate pre-existing urinary symptoms with segments of pelvic organ prolapse. Methods: All patients admitted with pelvic organ prolapse were included. Patients were asked regarding any concomitant urinary symptoms and then all patients were examined by POP-Q technique and correlation of urinary symptoms was done with various segments of pelvic organ prolapse. Results: Eighty patients were studied in one year duration. Majority of patients had presented with stage 4 prolapse (58.8%). Majority of patients had urinary symptoms among which 87.5% had increased urinary frequency, 88.8% had dysuria, 65% had stress urinary incontinence (SUI), 72.5% had incomplete evacuation. Dysuria and SUI was found to have significant correlation with anterior segment prolapse (p<0.05%). Conclusions: Site specific measurements by POP-Q system showed anterior segment prolapse to be more and were significantly associated with various urinary symptoms.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 26-29 DOI: http://dx.doi.org/10.3126/njog.v8i2.9765  

scholarly journals Evaluation of pelvic organ prolapse by standardized POP Q system for vaginal hysterectomy

2017 ◽  
Vol 6 (6) ◽  
pp. 2584 ◽  
Author(s):  
Vandana Dhama ◽  
Rachna Chaudhary ◽  
Shakun Singh ◽  
Manisha Singh
Keyword(s):  
Pelvic Organ Prolapse ◽  
Vaginal Hysterectomy ◽  
Age Groups ◽  
Pelvic Organ ◽  
Uterovaginal Prolapse ◽  
Genital Hiatus ◽  
Vaginal Length ◽  
The Mean ◽  
Anatomical Outcome ◽  
Q System

Background: Uterovaginal prolapse is a common condition affecting women in reproductive and perimenopausal age groups. Evaluating pelvic organ prolapse in an objective, reproducible, easy to apply method is required for proper management. Aim of the study was preoperative and postoperative evaluation of pelvic organ prolapse by POP Q system in patients undergoing vaginal hysterectomy.Methods: In this observational study, 100 patients having pelvic organ prolapse, (average age 48±12 years), underwent elective vaginal hysterectomy at Lala Lajpat Rai Memorial Medical College Meerut during June 2015 to July 2016. POP Q was done preoperatively and after completion of surgery by the same surgeon.Results: The mean of genital hiatus preoperatively was 6.4 and post operatively it was 3.64 i.e. the genital hiatus was reduced by 2.76. The mean of total vaginal length pre-operatively was 8.07 and post operatively was 7.2. There was only 0.9 cm reduction in the vaginal length. The mean of perineal body pre-operatively was 2.64 and post operatively was 3.64. The points preoperatively were Aa 2.35, Ba 2.61, C 2.57, Ap 2.24, Bp 0.96, D-4.79 and post-operative the value of the points was -2.19, -2.04,-5.57,-2.98,-2.52 respectively and D point absent due to hysterectomy.Conclusions: The post-operative POP Q was analysed and the patients having grade 0 were 63 (optimum anatomical outcome) and patients having grade 1 were 36 (satisfactory anatomical outcome).

scholarly journals Should we add unilateral sacrospinous ligament fixation to vaginal hysterectomy in management of stage 3 and stage 4 pelvic organ prolapse?

2015 ◽  
Vol 12 (3) ◽  
pp. 144-150 ◽  
Author(s):  
Elif Ağaçayak ◽  
Senem Yaman Tunç ◽  
Mehmet Sait İçen ◽  
Serdar Başaranoğlu ◽  
Fatih Mehmet Fındık ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Vaginal Hysterectomy ◽  
Pelvic Organ ◽  
Sacrospinous Ligament ◽  
Sacrospinous Ligament Fixation ◽  
Stage 4

scholarly journals To Compare the Effectiveness of Vaginal High Uterosacral Ligament Suspension and McCall's Culdoplasty during Vaginal Hysterectomy for Pelvic Organ Prolapse

2017 ◽  
Vol 5 (2) ◽  
pp. 81-86
Author(s):  
Krutika Bhalerao ◽  
Anuja V Bhalerao ◽  
Richa Garg
Keyword(s):  
Pelvic Organ Prolapse ◽  
Coming Out ◽  
Vaginal Hysterectomy ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Vaginal Vault ◽  
Care Hospital ◽  
Uterosacral Ligament Suspension ◽  
Vaginal Length ◽  
Vault Suspension

ABSTRACT Introduction Vaginal vault prolapse can be prevented by supporting the vaginal cuff, which is an essential part of hysterectomy, whether done abdominally or vaginally. The American Association of Gynecologic Laparoscopists (AAGL) has recommended for future research, specifically, a randomized trial comparing McCall's culdoplasty (with uterosacral ligament plication) with vaginal high uterosacral ligament suspension (HUSLS) (without plication), since both procedures are accessible to gynecological surgeons without urologic background. Hence, this study was carried out. Aim To compare both anatomic and functional outcomes of patients undergoing vaginal HUSLS or McCall's culdoplasty at the time of vaginal hysterectomy. Materials and methods This hospital-based prospective comparative study was carried out at a tertiary care hospital from January 1, 2013 to December 31, 2015 over a period of 3 years after obtaining Ethical Committee approval. All women attending gynecological outpatient department having symptom of mass coming out of vagina were subjected to detailed history, examination, and later underwent either HUSLS (43) or McCall's culdoplasty (42), for vault suspension with concomitant hysterectomy. The effectiveness of both the procedures was assessed by preoperative and postoperative pelvic organ prolapse quantification (POP-Q) and both were compared. Observations There was statistically significant improvement in all the sites of POP-Q points by HUSLS and McCall's culdoplasty as a method of vault suspension except in total vaginal length (TVL). Vault suspension by HUSLS is better than McCall's culdoplasty. All the points of POP-Q showed better results but the point C was significantly placed at a higher level by HUSLS (p = 0.000) as compared with McCall's culdoplasty. The time required for HUSLS was statistically more as compared with repair by McCall's culdoplasty (81.55/74.53 minutes, T: 1.981, p: 0.05). Complications, such as hemorrhage and ureteric injuries were more in HUSLS (2/43, 4.8%) as compared with McCall's culdoplasty (0/42); this is statistically significant. Conclusion High uterosacral ligament suspension provides excellent suspensory support to vaginal vault. Vagina is suspended over the levator ani with normal axis toward sacrum. By doing HUSLS, the vagina is symmetrically supported directed toward the hollow of sacrum. High uterosacral ligament suspension is highly recommended for young women with POP as vaginal length is not altered at all and so is the quality of life. How to cite this article Bhalerao AV, Bhalerao K, Garg R. To Compare the Effectiveness of Vaginal High Uterosacral Ligament Suspension and McCall's Culdoplasty during Vaginal Hysterectomy for Pelvic Organ Prolapse. J South Asian Feder Menopause Soc 2017;5(2):81-86.

Vaginal hysterectomy and risk of pelvic organ prolapse and stress urinary incontinence surgery

2011 ◽  
Vol 23 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Catharina Forsgren ◽  
Cecilia Lundholm ◽  
Anna L. V. Johansson ◽  
Sven Cnattingius ◽  
Jan Zetterström ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Vaginal Hysterectomy ◽  
Pelvic Organ ◽  
Incontinence Surgery ◽  
Stress Urinary Incontinence Surgery ◽  
Urinary Incontinence Surgery

scholarly journals Quality of life and vaginal symptoms of postmenopausal women using pessary for pelvic organ prolapse: a prospective study

2018 ◽  
Vol 64 (12) ◽  
pp. 1103-1107 ◽  
Author(s):  
Suelene C. Albuquerque Coelho ◽  
Marcos Marangoni-Junior ◽  
Luiz Gustavo Oliveira Brito ◽  
Edilson Benedito de Castro ◽  
Cássia Raquel Teatin Juliato
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Urinary Symptoms ◽  
Pelvic Surgery ◽  
Subjective Impression ◽  
Vaginal Symptoms ◽  
Sf 36 ◽  
A Prospective Study

SUMMARY OBJECTIVE: The use of pessary is an option for the conservative treatment of pelvic organ prolapse (POP). However, here are few studies assess the quality of life (QoL) after inserting the pessary for POP. We have hypothesized that the use of pessary would modify QoL in women with POP. METHODS: A prospective, observational study was performed that included 19 women with advanced POP. Pessary was introduced, and the SF-36 (general quality of life) and ICIQ-VS (vaginal symptoms and quality of life subdomain) questionnaires were applied before the introduction and after six months. A single question about the satisfaction regarding the use of the device was presented (subjective impression). RESULTS: The mean age of the women included was 76 years. Most of them were non-caucasian (52.6%), with no prior pelvic surgery (57.5%), with urinary symptoms (78.9%). A third of the patients reported sexual activity. After treatment, 22.2% of them presented vaginal infection, and 27.7% increased vaginal discharge. Urinary symptoms remained unaltered. Women reported 100% satisfaction after using the pessary (77.7% partial improvement; 22.3% total improvement). SF-36 had significant improvement in three specific domains: general state of health (p=0.090), vitality (p=0.0497) and social aspects (p=0.007). ICIQ-VS presented a reduction in the vaginal symptoms (p < 0.0001) and an improvement in QoL (P < 0.0001). CONCLUSION: The use of pessary for six months improved the QoL and reduced vaginal symptoms for women with advanced POP.

scholarly journals Correlation of Pelvic Organ Prolapse Quantification Technique with Pelvic Floor Dysfunction Symptoms

2019 ◽  
Vol 3 (3) ◽  
pp. 528-531
Author(s):  
Tarun Pradhan ◽  
Pappu Rijal ◽  
Baburam Dixit Thapa ◽  
Rabindra Dev Bhatta ◽  
Mohsina Hakkim ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
Observer Variation ◽  
Anatomical Site ◽  
Significant Relation ◽  
Site Specific ◽  
Genital Hiatus ◽  
A Prospective Study

Introduction: Assessment of POP by POP-Q gives anatomical site-specific measurement, which helps in surgery, follow-up and reduces inter-observer variation. The Pelvic Floor Distress Inventory (PFDI) is condition-specific health-related quality of life questionnaires for women with pelvic floor disorders. Objective: To assess pelvic organ prolapse by POP-Q technique and to correlate pelvic floor distress inventory questionnaire with POP-Q segments. Methodology A prospective study was done from March 2014 to February 2015 after ethical approval from IRC, B.P. Koirala Institute of Health Sciences. All patients with pelvic organ prolapse were included after informed verbal consent. The patients were then asked questions as in pelvic floor distress inventory questionnaire (PFDI) and noted in performa. The patients were then examined by POP-Q technique and noted. The informations were entered in the MS excel chart and statistical analysis done using SPSS 11.5. Results: There were 72 patients enrolled. The mean age of patients was 53.65 years. Majority of patients were found to have stage 4 prolapse (43.1%). POP-Q examination showed majority of patients had anterior and apical compartment defect. Correlation between POP-Q points and urinary symptoms showed significant relation with points in anterior compartment, genital hiatus and perineal bodies. Correlation with POP-Q points with colorectal symptoms showed involvement of genital hiatus significantly with strain stool and incomplete bowel movement. Correlation with pelvic distress symptoms with POP-Q sites showed significant relation with bulging, push up vagina for urination and defecation. Conclusion: POP-Q site specific points showed significant correlation with symptoms from Pelvic Floor Distress Inventry (PFDI) questionnaires.

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