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.

Modified Two-corner Raz Suspension Procedure for Cystocele Repair: A Novel Technique

2016 ◽  
Vol 8 (2) ◽  
pp. 130-135
Author(s):  
Urmila Sharma ◽  
Ritu Agarwal ◽  
Nilesh L Goraniya ◽  
Sumesh D Choudhary ◽  
Pradeep J Bandwal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stage Iv ◽  
Anterior Wall ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Stage Ii ◽  
Novel Technique

ABSTRACT Introduction Prolapse of anterior vaginal wall is a common problem in both perimenopausal and postmenopausal women. In past 200 years, surgical management of cystocele has undergone many changes from Kelly's plication to mesh reinforcement but none of these procedures proved to be 100% effective. Modified two-corner Raz suspension procedure (MTCRSP) can be used for the treatment of POP-Q (pelvic organ prolapse quantification) stage II to IV anterior vaginal wall prolapse (AVP). Objectives To assess the effectiveness of modified two-corner Raz suspension procedure (MTCRSP) in long-term success for cystocele repair and its effect on quality of life. Study design A hospital-based prospective study. Materials and methods Twelve patients underwent modified two-corner Raz procedure and were followed postoperatively for a period of 1 year at regular intervals. During follow-up, we assessed the degree of prolapse by POP-Q, quality of life, and sexual dysfunction. Results Preoperatively, 3 out of 12 (25%) patients had stage II, five had (41.66%) stage III, and four (33.33%) had stage IV prolapse. Postoperatively, at 1 month follow-up, one (8.33%) patient developed stage II anterior wall prolapse, which progressed to stage IV prolapse at 3 months. Two more patients developed stage II prolapse at 3-month follow-up. Failure rate at the end of 1 year was 25% (3/12). Prolapse quality of life (PQOL) improved in 10 out of 12 (83.33%) patients. While PGII (patient global impression of improvement) score improved in 11 out of 12 (91.66%) women. Conclusion Modified two-corner Raz suspension procedure is an effective technique with long-term success in stage II and III prolapse but a limited success in stage IV AVP. How to cite this article Mishra VV, Goraniya NL, Choudhary SD, Sharma U, Bandwal PJ, Tanvir T, Agarwal R. Modified Two-corner Raz Suspension Procedure for Cystocele Repair: A Novel Technique. J South Asian Feder Obst Gynae 2016;8(2):130-135.

scholarly journals Pelvic organ prolapse surgery and health-related quality of life: a follow-up study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tadesse Belayneh ◽  
Abebaw Gebeyehu ◽  
Mulat Adefris ◽  
Guri Rortveit ◽  
Janne Lillelid Gjerde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Prolapse Surgery ◽  
Stage Iii ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background Symptomatic prolapse impairs quality of life. Health-related quality of life (HRQoL) is considered an important outcome of pelvic organ prolapse (POP) surgery. However, it is rarely reported, and measures are inadequately used. Thus, studies reporting patient-reported surgical outcomes in low-income contexts are needed. This study aims to evaluate the effect of prolapse surgery on patient HRQoL and determine the predictive factors for change in HRQoL. Methods A total of 215 patients who had prolapse stage III or IV were enrolled. Patients underwent vaginal native tissue repair, and their HRQoL was evaluated at baseline, 3 and 6 months postoperatively. Effect of surgery on subjective outcomes were measured using validated Prolapse Quality of Life (P-QoL-20), Prolapse Symptom Score (POP-SS), Body Image in Prolapse (BIPOP), Patient Health Questionnaire (PHQ-9), and Patient Global Index of Improvement (PGI-I) tools. A linear mixed-effect model was used to compare pre- and postoperative P-QoL scores and investigate potential predictors of the changes in P-QoL scores. Results In total, 193 (89.7%) patients were eligible for analysis at 3 months, and 185 (86.0%) at 6 months. Participant’s mean age was 49.3 ± 9.4 years. The majority of patients had prolapse stage III (81.9%) and underwent vaginal hysterectomy (55.3%). All domains of P-QoL improved significantly after surgery. Altogether more than 72% of patients reported clinically meaningful improvement in condition-specific quality of life measured with P-QoL-20 at 6 months. An improvement in POP-SS, BIPOP, and the PHQ-9 scores were also observed during both follow-up assessments. At 6 months after surgery, only 2.7% of patients reported the presence of bulge symptoms. A total of 97.8% of patients had reported improvement in comparison to the preoperative state, according to PGI-I. The change in P-QoL score after surgery was associated with the change in POP-SS, PHQ, BIPOP scores and marital status (p < 0.001). However, age, type of surgery, and prolapse stage were not associated with the improvement of P-QoL scores. Conclusions Surgical repair for prolapse effectively improves patient’s HRQoL, and patient satisfaction is high. The result could be useful for patient counselling on the expected HRQoL outcomes of surgical treatment. Surgical service should be accessible for patients suffering from POP to improve HRQoL.

scholarly journals TOLTERODINE IMPROVES QUALITY OF LIFE IN PATIENTS WITH AN OVERACTIVE BLADDER, WITH OR WITHOUT URINARY INCONTINENCE: A PROSPECTIVE MULTICENTER STUDY

2010 ◽  
Vol 22 (1) ◽  
pp. 5
Author(s):  
F. Mantovani ◽  
G. Bozzini ◽  
P. Acquati ◽  
S.S. Di Pierro ◽  
M.G. Spinelli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Overactive Bladder ◽  
Clinical Effects ◽  
Health Questionnaire ◽  
Prospective Multicenter Study ◽  
Study Materials ◽  
Trial Entry ◽  
The Mean

AIMS: In order to analyse the effect of tolterodine on the Quality of life (QoL) of patients with overactive bladder (OB) we conducted a prospective multicentre clinical study. MATERIALS AND METHODS: Subjects were questioned at entry and 4, 12 and 24 weeks later about the number of micturitions and incontinent and urgency episodes/day, using a micturition diary. The mean volume voided per micturition and the number of pads used per day was also recorded. The QoL was measured using the Kings Health Questionnaire (KHQ) and the Incontinence Impact Questionnaire (IIQ). A total of 179 patients entered the study: 59 dropped out (4 due to lack of efficacy, 10 due to adverse events, 25 because of lack of interest in the study/other reason and 20 were lost at follow up), leaving 120 patients for analysis. One hundred and eight patients (90%) were female, their mean age was 56.5 years (SD 11.2); 87 had never received treatment for OB/UI (80.6%) and their mean weight was 70.0 Kg (SD 12.7). RESULTS: The mean number of micturitions/day was 9.3 at trial entry and it decreased to 6.8 by the end of the study. The corresponding values for the number of urge episodes, incontinence episodes and number of pads used per day were 3.5, 2.7 and 1.2 and 0.8, 0.9 and 0.4 respectively. The mean volume voided per micturition increased from 146 ml. to 178 ml. All the differences between trial entry and end of study values were statistically significant (p&lt;0.05). Considering the results of the KHQ, the values of all the different areas/domini (?) decreased markedly and in a statistically significant way between the start of treatment and the end of study evaluations. Similar findings emerged when we considered values of the IIQ. The decrease was constant and marked during the first three months and remained constant thereafter. CONCLUSIONS: This study, conducted in a population of subjects with dry and wet OB, shows that tolterodine given for six months lowers the frequency of urgency episodes and incontinence episodes without troublesome adverse effects. These clinical effects are mirrored in the QoL, KHQ and IIQ questionnaire scores, which improved by about 50% over the same period.

scholarly journals Cost-Effectiveness of perioperative Vaginally Administered estrogen in postmenopausal women undergoing prolapse surgery (EVA trial): study protocol for a multicenter double-blind randomized placebo-controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eva V. Vodegel ◽  
Sandra E. Zwolsman ◽  
Astrid Vollebregt ◽  
Ruben G. Duijnhoven ◽  
Judith E. Bosmans ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postmenopausal Women ◽  
Controlled Trial ◽  
Estrogen Therapy ◽  
Double Blind ◽  
Pop Surgery ◽  
Vaginal Estrogen ◽  
Vaginal Estrogen Therapy

Abstract Background Surgery for pelvic organ prolapse (POP) is associated with high recurrence rates. The costs associated with the treatment of recurrent POP are huge, and the burden from women who encounter recurrent POP, negatively impacts their quality of life. Estrogen therapy might improve surgical outcome for POP due to its potential beneficial effects. It is thought that vaginal estrogen therapy improves healing and long-term maintenance of connective tissue integrity. Hence, this study aims to evaluate the cost-effectiveness of perioperative vaginal estrogen therapy in postmenopausal women undergoing POP surgery. Methods The EVA trial is a multi-center double-blind randomized placebo-controlled trial conducted in the Netherlands comparing the effectiveness and costs-effectiveness of vaginal estrogen therapy. This will be studied in 300 postmenopausal women undergoing primary POP surgery, with a POP-Q stage of ≥ 2. After randomization, participants administer vaginal estrogen cream or placebo cream from 4 to 6 weeks preoperative until 12 months postoperative. The primary outcome is subjective improvement of POP symptoms at 1 year follow-up, measured with the Patient Global Impression of Improvement (PGI-I) scale. Secondary outcomes are POP-Q anatomy in all compartments, re-interventions, surgery related complications, general and disease specific quality of life, sexual function, signs and complaints of vaginal atrophy, vaginal pH, adverse events, costs, and adherence to treatment. Follow up is scheduled at 6 weeks, 6 months and 12 months postoperative. Data will be collected using validated questionnaires and out-patient visits including gynecological examination performed by an independent gynecologist. Discussion This study investigates whether perioperative vaginal estrogen will be cost-effective in the surgical treatment of POP in postmenopausal women. It is hypothesized that estrogen therapy will show a reduction in recurrent POP symptoms and a reduction in reoperations for POP, with subsequent improved quality of life among women and cost savings. Trial registrationNetherlands Trial Registry: NL6853; registered 19-02-2018, https://www.trialregister.nl/trial/6853. EudraCT: 2017-003144-21; registered: 24-07-2017.

scholarly journals Vaginal apical and anterior reconstruction using ultralight weight mesh: two-year follow-up

2018 ◽  
Vol 67 (3) ◽  
pp. 55-63
Author(s):  
Dmitry D. Shkarupa ◽  
Nikita D. Kubin ◽  
Eduard N. Popov ◽  
Ekaterina A. Shapovalova ◽  
Gleb V. Kovalev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
De Novo ◽  
Urine Volume ◽  
Operation Time ◽  
Pelvic Organ ◽  
Stage Ii ◽  
Apical Prolapse ◽  
Pelvic Floor Reconstruction

Introduction. Anterior and apical prolapse is the most common type of pelvic organ prolapse. The insufficient  effectiveness of native tissue repair in the pelvic organs leads to the search of new methods of the pelvic floor reconstruction. Objective. The current analysis was undertaken to evaluate the efficiency of the use of the Pelvix anterior mesh system (Lintex) with sacrospinous fixation of the apex in the treatment of anterior and apical prolapse. Methods. This study involved 150 women suffering from anterior-apical prolapse (stages III and IV). Reconstruction with the use of the mesh was performed in all the patients. To evaluate the results of surgical treatment, data of a vaginal examination (POP-Q), uroflowmetry, bladder ultrasound, and validated questionnaires (PFDI-20, PFIQ-7, PISQ-12) were used. All the listed parameters were determined before the surgery and on follow-up visits in 1, 6, 12, and 24 months after the treatment. Results. Mean operation time was 47 minutes. No cases of intraoperative clinically significant bleeding were reported. Anatomical cure rate (< stage II / asymptomatic stage II, according to the Baden-Walker system) at 12 months was found to be 94.4%, and at 24 months — 92.7%. Within the first month of follow-up, de novo stress urinary incontinence and de novo urgency occurred in 8.0% and 7.2% of patients, respectively. Statistically significant (p < 0.05) improvement in uroflowmetry parameters and decreased post-voiding urine volume were achieved after the surgery and did not change by 24 months. Comparison of the scores by the questionnaires revealed a significant improvement in the quality of life in the postoperative period. Conclusion. The use of the Pelvix anterior mesh system in the surgical correction of the anterior and apical prolapse is a safe uterus-sparing technique. At two-year follow-up, it provides a high anatomical efficiency, normalizes urodynamic parameters and improves quality of life.

Pelvic Organ Prolapse

2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Healthcare Provider ◽  
Treatment Options ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Life Threatening ◽  
Surgical Options

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall

Median TiMESH colporrhaphy with transobturator ligature fixation of the vaginal cuff as a method of surgical treatment for post-hysterectomy pelvic hernia

2021 ◽  
Vol 20 (5) ◽  
pp. 136-140
Author(s):  
A.I. Ishchenko ◽  
◽  
A.A. Ishchenko ◽  
I.D. Khokhlova ◽  
T.A. Dzhibladze ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Valsalva Maneuver ◽  
Disease Recurrence ◽  
Pelvic Organ ◽  
Titanium Implants ◽  
Vaginal Cuff ◽  
Gynecological Examination ◽  
Operation Duration

The analysis of clinical observation of 4 patients aged 68–78 years with post-hysterectomy pelvic hernia who were operated with the use of titanium implants and transobturator ligature fixation of the vaginal cuff according to the original technique is presented. Dynamic follow-up for 3–12 months after surgery showed the absence of pelvic organ prolapse during gynecological examination, Valsalva maneuver, and transperineal ultrasound. The questionnaire survey of patients showed their satisfaction with the results of surgery and improvement of their quality of life. Conclusion. Median TiMESH colporrhaphy with transobturator ligature fixation of the vaginal cuff in patients of elderly and senile age with post-hysterectomy pelvic hernia when slightly prolonging the operation duration contributes to strengthening and firm consolidation of the vaginal walls, elevation of the vaginal cuff and adjacent organs, improving the condition of the surgical scar and, therefore, improving patients’ quality of life and preventing disease recurrence. Key words: post-hysterectomy pelvic hernia, median TiMESH colporrhaphy, transobturator ligature fixation of the vaginal cluff

Pelvic Organ Prolapse

2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Healthcare Provider ◽  
Treatment Options ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Life Threatening ◽  
Surgical Options

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall

scholarly journals IMPACT OF URINARY INCONTINENCE ON THE QUALITY OF LIFE AND FEMALE SEXUALITY

2010 ◽  
Vol 20 (1) ◽  
pp. 5
Author(s):  
B. Adile ◽  
P. Palma ◽  
A. Pollina ◽  
S. Bandiera ◽  
M.L. Amico ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Overactive Bladder ◽  
Female Sexuality ◽  
Negative Impact ◽  
Mixed Incontinence ◽  
International Consultation ◽  
Before And After

The prevalence of urinary incontinence is around 20% of healthy middle-aged women. Incontinence has a negative impact on quality of life and sexuality. From August 2002 to January 2004, 30 patients (mean age 43 years) with stress urinary incontinence (59%) overactive bladder (15%0) and mixed incontinence (26%) answered the ICIQSF (International Consultation on Incontinence Questionnaire &ndash; Short From) and FSFI (Female Sexual Function Index) questionnaires before and after treatment. The follow up ranged from 12 to 53 months. Mean ICIQ score was 17 and 7 before and after treatment respectively (p&lt; 0,001). Overactive bladder showed the worst scores in all domains. The patients underwent surgery to increase desire (p=0,02), satisfaction (p=0,05) and t otal score (p=0,02). In 13 patients the ICIQ score did not increase: desire (p=0,01), satisfaction (p=0,05) and total score (p=0,01). Urinary incontinence significantly affects the quality of life. A sexuality evaluation in incontinence patients is recommended.

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