Sacrospinous hysteropexy – an alternative in primary surgical treatment of apical compartment prolapse

2021 ◽  
Vol 86 (3) ◽  
pp. 200-204
Author(s):  
Prokop Homola ◽  
◽  
Germund Hensel ◽  
Milan Košťál
Keyword(s):  
Surgical Treatment ◽  
Pelvic Organ Prolapse ◽  
Operation Time ◽  
Pelvic Organ ◽  
Complication Rates ◽  
Female Population ◽  
Sacrospinous Hysteropexy ◽  
Pubmed Database ◽  
Common Diagnosis ◽  
Apical Compartment

Summary Objective: To present a surgical treatment of pelvic organ prolapse and its outcomes according to the literature. Methods: PubMed database search. Conclusion: Pelvic organ prolapse is a common diagnosis with prevalence around 40% of female population. Vaginal delivery, especially with levator ani trauma, increasing age and obesity are the basic risk factors. Native tissue repair is a possible surgical treatment. Unfortunately, concomitant hysterectomy is still a very common procedure. It is established that uterus plays a passive role in pelvic organ prolapse. Sparing of the uterus keeps the original fixation structures and compartments intact and provides a solid tissue to anchor the stitches. Patients with benign and malign uterine diseases cannot have their uterus spared. In sacrospinous hysteropexy, nonabsorbable sutures are passed through the namesaked ligament on one or both sides to elevate the uterus. Several studies and their metaanalyses show comparable anatomical and functional outcomes with shorter operation time, decreased blood loss, faster recovery and lower complication rates in comparison with hysterectomy and uterosacral ligament fixation. In a prospective randomized control trial, sacrospinous hysteropexy provides significantly lower reoperation rate for apical compartment prolapse in a long-term follow-up. It is a safe and effective procedure for patients who wish to keep their uterus in place. Sacrospinous hysteropexy is an alternative in primary surgical treatment of pelvic organ prolapse.

scholarly journals Pelvic organ prolapse surgery and overactive bladder symptoms—a population-based cohort (FINPOP)

2021 ◽  
Author(s):  
Päivi K. Karjalainen ◽  
Anna-Maija Tolppanen ◽  
Nina K. Mattsson ◽  
Olga A.E. Wihersaari ◽  
Jyrki T. Jalkanen ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Overactive Bladder ◽  
Symptom Severity ◽  
Pelvic Organ ◽  
Population Based ◽  
Urinary Frequency ◽  
Posterior Compartment ◽  
Posterior Repair ◽  
Apical Compartment ◽  
Bothersome Symptom

Abstract Introduction and hypothesis It is unclear how compartment of pelvic organ prolapse (POP) impacts overactive bladder (OAB) symptom severity or improvement after POP surgery. We hypothesized that anterior and apical prolapse are more strongly associated with OAB symptoms than posterior compartment prolapse. Methods A total of 2933 POP surgeries from a prospective population-based cohort were divided into two groups: (1) anterior and/or apical compartment surgery (± posterior repair), N = 2091; (2) posterior repair only, N = 478. Urinary frequency and urgency urinary incontinence (UUI) were evaluated using PFDI-20 (bothersome symptom: score 3–4) at baseline, 6, and 24 months. Association between degree of POP in specific compartments and symptoms at baseline was estimated with generalized linear models and between compartment of surgery and symptom improvement with generalized estimating equations. Results At least one bothersome symptom was reported by 40% at baseline, 14% at 6, and 19% at 24 months. At baseline, urinary frequency was associated with degree of anterior and apical and UUI with anterior compartment prolapse. Women undergoing surgery for anterior/apical compartment started with worse symptoms and experienced greater improvement than women undergoing posterior compartment surgery. Bothersome frequency resolved in 82% after anterior/apical and in 63% after posterior compartment surgery. Bothersome UUI resolved in 75% after anterior/apical and in 61% after posterior compartment surgery. After surgery, symptom severity was comparable between groups. Bothersome de novo symptoms occurred in 1–3%. Conclusions OAB symptoms are more strongly related to anterior and apical than to posterior compartment prolapse, but improvement is seen after surgery for any vaginal compartment.

scholarly journals 168 Interprosthetic Fractures of The Femur: A Literature Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
F Marzano ◽  
V Pace ◽  
F Milazzo ◽  
A Caraffa ◽  
P Antinolfi
Keyword(s):  
Femur Fracture ◽  
Classification Systems ◽  
Surgical Approaches ◽  
High Morbidity ◽  
Complication Rates ◽  
Management Guidelines ◽  
Stress Risers ◽  
Pubmed Database ◽  
Common Diagnosis ◽  
Surgical Options

Abstract Increasing age expectations and number of joint replacement procedures have made interprosthetic femoral fractures (IFF) a progressively more common diagnosis and a challenge for surgeons. A gold standard and universally accepted classifications and guidelines do not exist yet. Customized structured electronic searches performed in PubMed database. Relevant key terms: IFF, classification interprosthetic fracture, peri-implant femoral fracture, biomechanics interprosthetic femur fracture, radiographic femur fracture, risk factor IFF. 42 articles finally included (up to 2019). High morbidity and mortality linked to IFF. Standardised classifications, management guidelines and surgical approaches are not available yet. Periprosthetic classification systems are still utilized even if not entirely appropriate. High rate of failure is related to thinner cortical bone, larger medullary canals and variable stresses depending on the distance among implants. High complication rates in all studies. Stress risers and implant stability based on fracture patterns and stress forces. Several surgical options with no uniformity. Less invasive surgical procedures are associated to reduction of metalwork failure rate, better preservation of vascularization and better functional-clinical outcomes. Lack of specific classification systems and management guidelines. Several surgical options are available with no uniformity of results. Attention to stress risers and preservation of bone stock and vascularization are key aspects for better results.

Use of a simple in vitro fatigue test to assess materials used in the surgical treatment of stress urinary incontinence and pelvic organ prolapse

2018 ◽  
Vol 38 (1) ◽  
pp. 107-115 ◽  
Author(s):  
Sabiniano Roman ◽  
Naside Mangir ◽  
Lucie Hympanova ◽  
Christopher R. Chapple ◽  
Jan Deprest ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Surgical Treatment ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Fatigue Test ◽  
Pelvic Organ ◽  
Materials Used

scholarly journals Pelvic Organ Prolapse in Countries of Different Economy: A Systematic Review

2019 ◽  
Vol 14 (2) ◽  
pp. 7-21
Author(s):  
Shishir Paudel ◽  
Anisha Chalise ◽  
Ganesh Dangal ◽  
Tulsi Ram Bhandari ◽  
Gehanath Baral
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Pelvic Organ Prolapse ◽  
Uterine Prolapse ◽  
National Income ◽  
Significant Risk ◽  
Pelvic Organ ◽  
Reference List ◽  
Medical Subject Headings ◽  
Pubmed Database

Aims: This review was done to identify the reported prevalence rate of pelvic organ prolapse among the different world populations. Methods: Systematic review of Pelvic Organ Prolapse (POP) using the PRISMA checklist; PubMed database was searched on reportingthe prevalence of POP and its management measures in January 2020. Medical Subject Headings (MeSH) like "Pelvic Organ Prolapse"OR "Uterine Prolapse" OR “Vaginal Wall Prolapse” OR "Cystocele"AND "Prevalence [key word/s]" were used. Additional articles were identified through the reference list of the retrieved articles. Results: Out of 91 screened articles, 46 full articles were eligible and only 15 satisfied by selection criteria for the systematic review.The methodological score rated for the quality of studies is 4.5±1.7 (range=2-7) out of 8 points. The mean prevalence of POP diagnosis was 40%; with 42.44% in low and lower-middle-income countries,and 35.56%in upper-middle and high-income countries. Increasing age and parity, body mass indexand fetal macrosomia were found to be the significant risk factors irrespective of the country’s economy. Conclusions:The low and lower-income countries have almost twice the burden of prolapse than the countries of the higher economy. The major risk factors associated with prolapse remain common in all countries irrespective of national income or development.  

Two-Year Experience with Elevate ® Anterior and Apical (EAA) with IntePro ® Lite™ in the Surgical Treatment of Pelvic Organ Prolapse

2012 ◽  
Vol 19 (6) ◽  
pp. S31
Author(s):  
E.J. Stanford ◽  
R.D. Moore ◽  
J.-P.R.W. Roovers ◽  
D. VanDrie ◽  
J.C. Lukban ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ

scholarly journals Erratum to: Prediction model and prognostic index to estimate clinically relevant pelvic organ prolapse in a general female population

2010 ◽  
Vol 21 (3) ◽  
pp. 387-388
Author(s):  
Marijke Slieker-ten Hove ◽  
Annelies Pool-Goudzwaard ◽  
Marinus Eijkemans ◽  
Regine Steegers-Theunissen ◽  
Curt Burger ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Prediction Model ◽  
Prognostic Index ◽  
Pelvic Organ ◽  
Female Population
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