scholarly journals A New Surgical Method of Suprapubic and Extraperitoneal Approach with Uterine Preservation for Pelvic Organ Prolapse: Kurt Extraperitoneal Ligamentopexy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Sefa Kurt ◽  
Mehmet Tunc Canda ◽  
Abdullah Tasyurt
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Uterine Preservation ◽  
Pop Surgery ◽  
Burch Procedure ◽  
The Mean ◽  
Manchester Procedure ◽  
Rectus Fascia

Objective. To introduce an alternative surgical approach for the optimal treatment of pelvic organ prolapse (POP). Methods. Twenty symptomatic women with grades 2–4 POP diagnosis who opted to choose this alternative surgery were retrospectively analyzed. Results. A total of 22 cases were included. The mean age of the patients was 50.6±13.2 years (29–72 years) with a mean gravid and parity of 5.5±2.66 and 3.4±2.06, respectively. The mean body-mass index of the patients was 24.25±2.43. Nine (45%) patients were premenopausal and 11 (55%) patients were postmenopausal. Uterine descensus was present in all patients, and additionally cystorectocele in 9 patients (45%), cystocele in 6 patients (30%), rectocele in 4 patients (20%), and elangatio colli in 6 patients (30%) were diagnosed. In addition to the alternative surgery, Manchester procedure and anteroposterior vaginal wall repair or Burch procedure was performed where necessary. Mean follow-up time was 48.95±42.8 months (6–171 months). No recurrence of POP occurred. Conclusions. Suprapubic, extraperitoneal, and minimally invasive ligamentopexy of the round ligament to the anterior rectus fascia offers an alternative to conventional POP surgery with favorable outcomes without any recurrence.

scholarly journals Pregnancy and Vaginal Delivery after Sacrohysteropexy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Deniz Balsak ◽  
Ahmet Eser ◽  
Onur Erol ◽  
Derya Deniz Altıntaş ◽  
Şerif Aksin
Keyword(s):  
Pelvic Organ Prolapse ◽  
Vaginal Delivery ◽  
Rare Condition ◽  
Pelvic Organ ◽  
Vaginal Birth ◽  
Pop Surgery ◽  
Long Term Follow Up ◽  
Pregnancy And Birth

Pregnancy and birth after a Pelvic Organ Prolapse (POP) surgery is a rare condition and less is known about the method for delivery. A 31-year-old women with gravida 3 para 3 underwent abdominal sacrohysteropexy and transobturatuar tape (TOT) procedures for stage III prolapse who delivered via vaginal birth and showed no relapse. Sacrohysteropexy is a good option for women with POP who desire fertility with a long term follow-up period.

scholarly journals Transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension: pilot study of 35 cases of severe pelvic organ prolapse

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhiying Lu ◽  
Yisong Chen ◽  
Xiaojuan Wang ◽  
Junwei Li ◽  
Keqin Hua ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Uterosacral Ligament Suspension ◽  
Efficacy And Safety ◽  
Natural Orifice ◽  
Short Term ◽  
Before And After ◽  
The Mean

Abstract Background To describe the short-term outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for uterosacral ligament suspension (USLS) in patients with severe prolapse. Methods This was a retrospective study of patients with severe prolapse (≥ stage 3) who underwent vNOTES for USLS between May 2019 and July 2020. The Pelvic Organ Prolapse Quantification (POP-Q) score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and Pelvic Floor Inventory-20 (PFDI-20) were used to evaluate physical prolapse and quality of life before and after vNOTES for USLS. Results A total of 35 patients were included. The mean operative duration was 111.7 ± 39.4 min. The mean blood loss was 67.9 ± 35.8 ml. Statistically significant differences were observed between before and after vNOTES USLS in Aa (+ 0.6 ± 1.7 versus − 2.9 ± 0.2), Ba (+ 1.9 ± 2.2 versus − 2.9 ± 0.3), C (+ 1.5 ± 2.2 versus − 6.9 ± 0.9), Ap (− 1.4 ± 1.0 versus − 3.0 ± 0.1) and Bp (− 1.1 ± 1.4 versus − 2.9 ± 0.1) (P < 0.05 for all). The mean pre- and postoperative PFDI-20 score was 19.9 ± 6.7 and 3.2 ± 5.4, respectively, and the mean pre- and postoperative PISQ-12 score was 24.8 ± 2.3 and 38.3 ± 4.1, respectively (P < 0.05 for both). During 1–13 months of follow-up, there were no cases of severe complications or recurrence. Conclusions vNOTES for USLS may be a feasible technique to manage severe prolapse, with promising short-term efficacy and safety. Larger studies with more patients and longer follow-up periods should be performed to evaluate the long-term efficacy and safety profile of vNOTES for USLS.

scholarly journals Laparoscopic lateral suspension for anterior and apical prolapse: a prospective cohort with standardized technique

2021 ◽  
Author(s):  
Kyriaki Chatziioannidou ◽  
Nikolaus Veit-Rubin ◽  
Patrick Dällenbach
Keyword(s):  
Pelvic Organ Prolapse ◽  
Perioperative Complications ◽  
Pelvic Organ ◽  
Reoperation Rate ◽  
Pop Surgery ◽  
Gynecological Examination ◽  
Absorbable Sutures ◽  
Laparoscopic Lateral Suspension ◽  
Pop Repair

Abstract Introduction and hypothesis Laparoscopic lateral suspension (LLS) for anterior and apical pelvic organ prolapse (POP) repair is a recent approach. Previous studies used various meshes or sutures. The purpose of this study was to evaluate outcomes of a standardized LLS technique. Methods From January 2010 until December 2014, we performed POP repair by LLS with mesh on 88 women with anterior and apical POP ≥ stage 2. We used a polypropylene titanized mesh fixed to the vesico-vaginal fascia with absorbable sutures and treated posterior compartment defect by vaginal approach with native tissue repair if required. Between July 2013 and December 2018, all women were assessed by gynecological examination including the pelvic organ prolapse quantification (POP-Q) system. Subjective outcome was evaluated by the patient global impression of improvement (PGI-I) questionnaire. Results Seventy-nine women (89.8%) were available for follow-up. The mean duration of follow-up was 3.4 years (SD 1.6). Mean age was 59.6 (SD 11.1) years and mean BMI 25.8 (SD 4.0) kg/m2. Ten patients (12.7%) had previous POP surgery. Fifty-two women (65.8%) required posterior colporraphy for associated posterior defect and 21 (26.6%) had associated urinary incontinence (UI) surgery. There were no perioperative complications. The objective cure rate (no prolapse beyond the hymen and no reoperation for POP recurrence) was 87.3%. The reoperation rate for recurrence was 5.1%. The subjective success rate (PGI ≤ 2) was 96.2%. There were no mesh exposures or extrusions. Conclusions This standardized LLS is safe and effective with no mesh complications after 3-year follow-up.

scholarly journals Sacrocolpopexy using autologous rectus fascia: cohort study of long-term outcomes and complications

2021 ◽  
Author(s):  
Rui Wang ◽  
Krista Reagan ◽  
Sarah Boyd ◽  
Paul Tulikangas
Keyword(s):  
Cohort Study ◽  
Pelvic Organ Prolapse ◽  
Medical Center ◽  
Academic Medical Center ◽  
Pelvic Organ ◽  
Synthetic Mesh ◽  
Composite Failure ◽  
Abdominal Sacrocolpopexy ◽  
Rectus Fascia

Objective: To evaluate objective and subjective outcomes of patients who underwent sacrocolpopexy using autologous rectus fascia to provide more data regarding non-mesh alternatives in pelvic organ prolapse surgery. Design: Cohort study with retrospective and prospective data. Setting: A single academic medical center. Population: Women who underwent abdominal sacrocolpopexy using autologous rectus fascia between January 2010 and December 2019 Methods: Patients were recruited for a follow-up visit including completing the Pelvic Floor Distress Inventory (PFDI) and Pelvic Organ Prolapse Quantification (POPQ) exam. Demographic and clinical characteristics were collected. Main Outcome Measures: Composite failure, anatomic failure, symptomatic failure, and retreatment. Results: During the study period, 132 women underwent sacrocolpopexy using autologous rectus fascia. Median follow-up time was 2.2 years. Survival analysis showed that composite failure was 0.8% (CI 0.1-5.9%) at 12 months, 3.5% (CI 1.1-10.7%) at 2 years, 13.2% (CI 7.0-24.3%) at 3 years, and 28.3% (CI 17.0-44.8%) at 5 years. Anatomic failure was 0% at 12 months, 1.4% (CI 0.2-9.2%) at 2 years, 3.1% (CI 0.8-12.0%) at 3 years, and 6.8% (CI 2.0-22.0%) at 5 years. Symptomatic failure rate was 0% at 12 months, 1.3% (CI 0.2-9.0%) at 2 years, 2.9% (CI 0.7-11.3%) at 3 years, and 13.1% (CI 5.3-30.3%) at 5 years. Retreatment rate was 0.8% (CI 0.1-5.9%) at 12 months and 2 years, 9.4% (CI 4.2-20.3%) at 3 years, and 13.0% (CI 6.0-27.2%) at 5 years. Conclusions: Autologous rectus fascia sacrocolpopexy may be considered a safe and effective alternative for patients who desire to avoid synthetic mesh.

scholarly journals Pelvic Organ Prolapse and Uterine Preservation: A survey of female gynaecologists (POP-UP survey)

2020 ◽  
Author(s):  
Peter Urdzík ◽  
Vladimir Kalis ◽  
Mija Blaganje ◽  
Zdenek Rusavy ◽  
Martin Smazinka ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Uterine Cancer ◽  
Information Provision ◽  
Pelvic Organ ◽  
Management Options ◽  
Uterine Preservation ◽  
The Czech Republic ◽  
Pop Surgery ◽  
Anatomical Success ◽  
Anatomical Outcome

Abstract Backround: The aim of this study was to explore the personal views of female gynecologists regarding the management of POP with a particular focus on the issue of uterine sparing surgery. Methods: A questionnaire based survey of practicing female gynaecologists in the Czech Republic, Slovenia and Slovakia. Results : A total of 140 female gynaecologists from 81 units responded to our questionnaire. The majority of respondents stated they would rely on a urogynecologist to aid them with their choice of POP management options. The most preferred options for POP management were sacrocolpopexy and physiotherapy. Almost 2/3 of respondents opted for a hysterectomy together with POP surgery, if they were menopausal, even if the anatomical outcome was similar to uterine sparing POP surgery. Moreover, 81.4% of respondents, who initially opted for a uterine sparing procedure, changed their mind if the anatomical success of POP surgery with concomitant hysterectomy was superior. Discussing uterine cancer risk in relation to other organs had a less significant impact on their choices. Conclusions: The majority of female gynecologists in our study opted for hysterectomy if they were postmenopausal at the time of POP surgery. However, variation in information provision had an impact on their choice.

scholarly journals Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Uterosacral Ligament Suspension: a Pilot Study of 35 Caseswith Severe Pelvic Organ Prolapse

2021 ◽  
Author(s):  
Zhiying Lu ◽  
Yisong Chen ◽  
Xiaojuan Wang ◽  
Junwei Li ◽  
Keqin Hua ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Endoscopic Surgery ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Uterosacral Ligament Suspension ◽  
Natural Orifice ◽  
Short Term ◽  
Before And After ◽  
The Mean

Abstract Background To describe the short-term outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for uterosacral ligament suspension (USLS) in patients with severe prolapse.Methods This is a retrospective study conducted for patients with severe prolapsed (≥stage 3) who underwent vNOTES USLS between May 2019 and July 2020. The Pelvic Organ Prolapse Quantification (POP-Q) score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and Pelvic Floor Inventory-20 (PFDI-20) were used to evaluate physical prolapse and quality of life before and after vNOTES USLS.Results A total of 35 patients were included. The mean operative time was 111.7±39.4 minutes. The mean blood loss was 67.9±35.8 ml. Statistically significant differences were observed before and after vNOTES USLS in regard to Aa (+0.6±1.7 versus −2.9±0.2), Ba (+1.9±2.2 versus −2.9±0.3), C (+1.5±2.2 versus -6.9±0.9), Ap (-1.4±1.0 versus −3.0±0.1) and Bp (-1.1±1.4 versus −2.9±0.1) (P < 0.05 for all). The mean pre- and post-operative PFDI-20 score was 19.9±6.7 versus 3.2±5.4, and the PISQ-12 score was 24.8±2.3 versus 38.3±4.1 (P < 0.05 for both). During 1–13 months of follow-up, no severe complications or recurrence.Conclusions vNOTES USLS may be a feasible technique to manage severe prolapse, with promising short-term efficacy and safety data. However, a study with a larger number of patients and a longer follow-up period should be conducted.

scholarly journals Pelvic Organ Prolapse and Uterine Preservation: A survey of female gynaecologists (POP-UP survey)

2020 ◽  
Author(s):  
Peter Urdzík ◽  
Vladimir Kalis ◽  
Mija Blaganje ◽  
Zdenek Rusavy ◽  
Martin Smazinka ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Uterine Cancer ◽  
Information Provision ◽  
Pelvic Organ ◽  
Management Options ◽  
Uterine Preservation ◽  
The Czech Republic ◽  
Pop Surgery ◽  
Anatomical Success ◽  
Anatomical Outcome

Abstract Background: The aim of this study was to explore the personal views of female gynecologists regarding the management of POP with a particular focus on the issue of uterine sparing surgery. Methods: A questionnaire based survey of practicing female gynecologists in the Czech Republic, Slovenia and Slovakia.Results: A total of 140 female gynecologists from 81 units responded to our questionnaire. The majority of respondents stated they would rely on a urogynecologist to aid them with their choice of POP management options. The most preferred options for POP management were sacrocolpopexy and physiotherapy. Almost 2/3 of respondents opted for a hysterectomy together with POP surgery, if they were menopausal, even if the anatomical outcome was similar to uterine sparing POP surgery. Moreover, 81.4% of respondents, who initially opted for a uterine sparing procedure, changed their mind if the anatomical success of POP surgery with concomitant hysterectomy was superior. Discussing uterine cancer risk in relation to other organs had a less significant impact on their choices.Conclusions: The majority of female gynecologists in our study opted for hysterectomy if they were postmenopausal at the time of POP surgery. However, variation in information provision had an impact on their choice.Trial registration: not included

scholarly journals Pelvic Organ Prolapse and Uterine Preservation: A survey of female gynaecologists (POP-UP survey)

2020 ◽  
Author(s):  
Peter Urdzík ◽  
Vladimir Kalis ◽  
Mija Blaganje ◽  
Zdenek Rusavy ◽  
Martin Smazinka ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Uterine Cancer ◽  
Information Provision ◽  
Pelvic Organ ◽  
Management Options ◽  
Uterine Preservation ◽  
The Czech Republic ◽  
Pop Surgery ◽  
Anatomical Success ◽  
Anatomical Outcome

Abstract Background: The aim of this study was to explore the personal views of female gynecologists regarding the management of POP with a particular focus on the issue of uterine sparing surgery.Methods: A questionnaire based survey of practicing female gynecologists in the Czech Republic, Slovenia and Slovakia.Results: A total of 140 female gynecologists from 81 units responded to our questionnaire. The majority of respondents stated they would rely on a urogynecologist to aid them with their choice of POP management options. The most preferred options for POP management were sacrocolpopexy and physiotherapy. Almost 2/3 of respondents opted for a hysterectomy together with POP surgery, if they were menopausal, even if the anatomical outcome was similar to uterine sparing POP surgery. Moreover, 81.4% of respondents, who initially opted for a uterine sparing procedure, changed their mind if the anatomical success of POP surgery with concomitant hysterectomy was superior. Discussing uterine cancer risk in relation to other organs had a less significant impact on their choices.Conclusions: The majority of female gynecologists in our study opted for hysterectomy if they were postmenopausal at the time of POP surgery. However, variation in information provision had an impact on their choice.

scholarly journals Assessment of Overactive Bladder after Laparoscopic Lateral Suspension for Pelvic Organ Prolapse

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ewelina Malanowska ◽  
Andrzej Starczewski ◽  
Włodzimierz Bielewicz ◽  
Matteo Balzarro
Keyword(s):  
Quality Of Life ◽  
Overactive Bladder ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Wall Defect ◽  
Pop Surgery ◽  
Laparoscopic Lateral Suspension

Background. Pelvic organ prolapses (POP) and overactive bladder (OAB) may coexist and both negatively impact quality of life in women. The correlation between POP and OAB remains unclear, but these patients may have the OAB resolution after the surgical treatment of POP. Aim of our study was to assess the anatomical results and the effect on OAB symptoms in women who underwent laparoscopic lateral suspension for POP. Materials and Methods. This prospective study included all women with apical POP who underwent surgical repair with laparoscopic uterine lateral suspension from January 2016 to December 2017. The baseline and the 1-year follow-up included post-void residual measurement, urinalysis, vaginal examination, OAB symptoms evaluation, and administration of questionnaires (PFDI-20, UDI 6). Results. 64 women underwent laparoscopic lateral suspension for uterine prolapse and 78.1% had concomitant anterior vaginal wall defect. At 1-year follow-up the anatomic success rates were 84.4% for the apical and 76.2% for the anterior compartment. The comparison between OAB symptoms before and after the surgical procedure showed the resolution of OAB in 76% of the women, while de novo OAB was present in 2.6%. With the questionnaires 95.3% (61/64) of our patients were satisfied after the POP repair. We documented a trend in ameliorating of OAB regardless of the POP-Q stage. However, the Pearson test showed this correlation as statistically significant only in women with anterior vaginal wall defect stage III and apical stage II. No patient had vaginal exposure of the polypropylene mesh. Conclusion. Our data show how laparoscopic lateral suspension is an effective procedure for apical and anterior vaginal wall defects. This study provides further evidence for the concept that OAB in women with POP >II stage improves after a successful POP surgery. These women may benefit from a resolution of OAB and POP symptoms with the improvement of patient’s quality of life.

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