Laparoscopic Reconstructive Surgery is Superior to Vaginal Reconstruction in the Pelvic Organ Prolapse

Abstract Introduction and hypothesis This study aimed to investigate the evaluation and management of complications after pelvic floor reconstructive surgery for pelvic organ prolapse in China. Methods Complications of pelvic floor reconstructive surgery for pelvic organ prolapses from 27 institutions were reported from November 2017 to October 2019. All complications were coded according to the category-time-site system proposed by the International Urogynecological Association (IUGA) and the International Continence Society (ICS). The severity of the complications was graded by the Clavien-Dindo grading system. Four scales were used to evaluate patient satisfaction and quality of life after management of the complications: the Patient Global Impression of Improvement (PGI-I), the Pelvic Floor Impact Questionnaire Short Form (PFIQ-7), the Pelvic Organ Prolapse Symptom Score (POP-SS), and a 5-point Likert-type scale that evaluated the patient’s choice of surgery. Results Totally, 256 cases were reported. The occurrence of complications related to transvaginal mesh (TVM) and laparoscopic sacrocolpopexy (LSC) had a significantly longer post-surgery delay than those of native tissue repair surgery (p < 0.001 and p = 0.010, respectively). Both PFIQ-7 and POP-SS score were lower after management of complications (p < 0.001). Most respondents (81.67%) selected very much better, much better, or a little better on the PGI-I scale. Only 13.3% respondents selected unlikely or highly unlikely on the 5-point Likert-type scale. Conclusions The occurrence of complications related to TVM surgery and LSC had a longer post-surgery delay than native tissue repair surgery. Long-term regular follow-up was vital in complication management. Patient satisfaction with the management of TVM complications was acceptable.

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39: Does specialization in female pelvic medicine and reconstructive surgery affect procedure type for vaginal repair of pelvic organ prolapse?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.01.069 ◽

2019 ◽

Vol 220 (3) ◽

pp. S732-S734

Author(s):

D. Sheyn ◽

C.E. Bretschneider ◽

J. Mangel ◽

S.A. El-Nashar ◽

A. Hijaz ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Reconstructive Surgery ◽

Pelvic Organ ◽

Vaginal Repair ◽

Female Pelvic Medicine ◽

Procedure Type

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Prevalence and clinical predictors for early post-operative urinary retention in patients undergoing pelvic reconstructive surgeries: a prospective cohort study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181334 ◽

2018 ◽

Vol 7 (4) ◽

pp. 1452

Author(s):

Annie P. Vijjeswarapu ◽

Vaibhav Londhe ◽

Mahasampath Gowri ◽

Aruna Kekre ◽

Nitin Kekre

Keyword(s):

Cohort Study ◽

Pelvic Organ Prolapse ◽

Urinary Retention ◽

Prospective Cohort Study ◽

Reconstructive Surgery ◽

Prospective Cohort ◽

Pelvic Organ ◽

P Value ◽

Pelvic Reconstructive Surgery ◽

Clinical Predictors

Background: Pelvic organ prolapse (POP) has a significant impact on quality of life. Post-operative voiding dysfunction is seen in 2.5 to 24% of patients following pelvic reconstructive surgery. Risk factors like age of the patient, size of the genital hiatus and stage of prolapse are known to be associated with early post-operative voiding disorders.Methods: This is a prospective cohort study done in Christian Medical College, Vellore over one year. Patients with stage II to IV pelvic organ prolapse who underwent pelvic reconstructive surgery were observed post operatively for covert and overt urinary retention. Inability to void accompanied by pain and discomfort is defined as overt retention. Early post-operative urinary retention (POUR) is retention of urine in the first 72 hours postoperatively. Covert retention is defined as a non-painful bladder with chronic high post void residue. Chi- square test or Fisher’s exact test was used to assess the association between the clinical predictors and early post-operative urinary retention in univariate analysis.Results: In this study, 75 patients were recruited. Nine patients had POUR. Among the patients who had post-operative urinary retention, 77.78% had stage III pelvic organ prolapse (n=7). P value was 0.042. The prevalence of early POUR after pelvic reconstructive surgery was 12.85 % (n=9). A 55.55% had covert retention (n=5) and 44.44% patients had overt retention (n=4).Conclusions: The prevalence of early POUR after pelvic reconstructive surgery was 12.85%. Stage of the prolapse was an independent predictor for early postoperative urinary retention.

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