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

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.

Efficacy and safety of skeletonized mesh implants for advanced pelvic organ prolapse: 12-month follow-up

2016 ◽  
Vol 34 (10) ◽  
pp. 1491-1498 ◽  
Author(s):  
Adi Y. Weintraub ◽  
Menahem Neuman ◽  
Yonatan Reuven ◽  
Joerg Neymeyer ◽  
Naama Marcus-Braun
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Efficacy And Safety ◽  
Advanced Pelvic Organ Prolapse

Comment on “efficacy and safety of skeletonized mesh implants for advanced pelvic organ prolapse: 12 month follow up”

2016 ◽  
Vol 34 (10) ◽  
pp. 1499-1500 ◽  
Author(s):  
Antonio Simone Laganà ◽  
Fabrizio Sapia ◽  
Salvatore Butticè ◽  
Gaetano Valenti ◽  
Salvatore Giovanni Vitale
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Efficacy And Safety ◽  
Advanced Pelvic Organ Prolapse

The effect of reconstructive vaginal surgery on quality of life and sexual functions in postmenopausal women with advanced pelvic organ prolapse in intermediate-term follow-up

2021 ◽  
pp. 205336912110097
Author(s):  
Suna Y Karaca
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Sexual Function ◽  
Pelvic Organ ◽  
Sacrospinous Ligament ◽  
Sacrospinous Ligament Fixation ◽  
Mccall Culdoplasty ◽  
Advanced Pelvic Organ Prolapse

Objective To compare sexual function and quality of life in women who underwent McCall culdoplasty versus sacrospinous ligament fixation for pelvic organ prolapse. Materials and methods This study was conducted in our urogyanecology clinic between July 2015 and June 2019. We included sexually active postmenopausal women who had undergone either McCall culdoplasty ( n:80 patients) or sacrospinous ligament fixation ( n:38 patients) procedure for threatened POP. Patients in both groups were matched according to age and body mass index. Sexual function between both groups was evaluated with the pelvic organ prolapse/urinary incontinence sexual function 12 patient-reported outcome measures (PROMs) and quality of life with the prolapse quality of life (PQOL) PROMs. Results Emotional domain was low in the McCall culdoplasty group (21.4 ± 10.1 vs. 30.8 ± 15.2; p = 0.03). There were no significant differences in other P-QOL domains. Pain during intercourse was more in the sacrospinous ligament fixation group (2.9 ± 1.6 vs. 1.3 ± 1.1; p = 0.04). The mean operation time in the McCall culdoplasty group was shorter than the sacrospinous ligament fixation group ( p = 0.03). There was no difference between the two surgical procedures performed in terms of intraoperative blood loss and hospital stay. The prevalence of recurrence in the McCall culdoplasty group was 6.2%, and that of sacrospinous ligament fixation was 5% ( p = 0.75) in one year follow-up. Conclusion Our study demonstrated that McCall culdoplasty has a more positive effect on QOL and sexuality than sacrospinous ligament fixation in appropriately selected patients. McCall culdoplasty could be considered as a good option in the treatment of advanced pelvic organ prolapse in elderly patients.

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.

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