Vaginal vault reconstruction and apical sling in the treatment of post-hysterectomy prolapsE
- 作者: Shkarupa D.D1, Bezmenko A.A2, Kubin N.D1, Shapovalova E.A1, Pisarev A.V1
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隶属关系:
- University Clinic of Saint Petersburg State University
- S.M. Kirov Military Medical Academy
- 期: 卷 66, 编号 1 (2017)
- 页面: 46-55
- 栏目: Articles
- URL: https://ogarev-online.ru/jowd/article/view/6095
- DOI: https://doi.org/10.17816/JOWD66146-55
- ID: 6095
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Introduction. Frequency of vaginal vault prolapse (VVP) requiring surgical repair is up to 6-8% and 11.6-45% in patients with prior hysterectomy for uterine prolapse. Reported recurrence rate of VVP following different techniques of surgical correction is up to 10%.
Objective: to evaluate the effectiveness of the novel technique: bilateral sacrospinous fixation of reconstructed vaginal wall (neocervix) by monofilament polypropylene apical sling (Urosling 1; Lintex, Saint Petersburg, Russia) in surgical treatment of VVP.
Methods. This prospective study involved 61 women suffering from post-hysterectomy prolapse. To evaluate the results of surgical treatment, data of a vaginal examination (POP-Q), uroflowmetry, bladder ultrasound, validated questionnaires were used. All listed parameters were determined before the surgery and at control examinations in 1, 6, 12 months after the treatment.
Results. Mean operation time was 35 minutes. No cases of intraoperative damage to the bladder/rectum, as well as clinically significant bleeding were noted. 12-months anatomical cure rate (≤ stage I, POP-Q) was 100%, 94.4% and 100% for apical, anterior and posterior vaginal compartments, respectively. At 1 month of follow-up stress urinary incontinence de novo and urgency de novo were noted in 6.5% and 4.9%, respectively. Statistically significant (p < 0.05) improvement in peak flow rate was observed according to uroflowmetry. Comparison of the scores by the questionnaires revealed a significant improvement in the quality of life in the postoperative period.
Conclusion. Bilateral sacrospinous fixation of reconstructed vaginal wall (neocervix) by monofilament polypropylene apical sling appears to be effective and safe method for treatment patients with vaginal vault prolapse.
作者简介
Dmitry Shkarupa
University Clinic of Saint Petersburg State University
编辑信件的主要联系方式.
Email: shkarupa.dmitry@mail.ru
Ph.D., Deputy Director for medical care, Chief Urologist 俄罗斯联邦
Alexandr Bezmenko
S.M. Kirov Military Medical Academy
Email: bezmenko@yandex.ru
Ph.D., Obstetrician-gynecologist of the Department of Obsterics and Gynecology, Assistant of the Department of Obsterics and Gynecology 俄罗斯联邦
Nikita Kubin
University Clinic of Saint Petersburg State University
Email: nikitakubin@gmail.com
Ph.D., Urologist of the Department of Urology 俄罗斯联邦
Ekaterina Shapovalova
University Clinic of Saint Petersburg State University
Email: Katerina_andmed@mail.ru
Obstetrician-gynecologist of the Gynecology Department 俄罗斯联邦
Alexey Pisarev
University Clinic of Saint Petersburg State University
Email: alexey.v.pisarev@gmail.com
Urologist of the Department of Urology 俄罗斯联邦
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