STUDY OBJECTIVE:To assess the clinical outcomes of total mesh repair with the Prolift technique as treatment of advanced pelvic organ prolapse in elderly patients who desire uterine preservation.
DESIGN: Case control series study (Canadian Task Force classification II-2).
SETTING: Medical school-affiliated hospital.
PATIENTS: Sixty-eight patients over the age of 70 years with advanced pelvic organ prolapse, Pelvic Organ Prolapse Quantification stage III (n = 59) or IV (n = 9), underwent a total Prolift procedure and were followed up for a minimum of 2 years.
INTERVENTIONS: Transvaginal pelvic floor repairs were performed with a total Prolift system. The concurrent pelvic surgery included midurethral sling operation with a TVT-O, if indicated. The assessment included intraoperative and postoperative complications, Urogenital Distress Inventory scores, and Incontinence Impact Questionnaire scores.
MEASUREMENTS AND MAIN RESULTS: Objective and subjective data were available for 68 patients. The anatomic success rate was 97.1% after 2 years. Complications included bladder perforation in 1 patient (1.5%), de novo stress urinary incontinence in 20 patients (29.4%), dyspareunia in 4 patients (22.2%), and vaginal erosion in 1 patient (1.5%). The Pelvic Organ Prolapse Quantification stages, Urogenital Distress Inventory scores, and Incontinence Impact Questionnaire scores all improved significantly after surgery.
CONCLUSIONS: The total Prolift procedure is an alternative surgical option that uses a minimally invasive transvaginal approach to surgically treat elderly patients with advanced pelvic organ prolapse.
Written by:
Cho MK, Kim CH, Kang WD, Kim JW, Kim SM, Kim YH. Are you the author?
Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Korea.
Reference: J Minim Invasive Gynecol. 2012 Jan 26. Epub ahead of print.
doi: 10.1016/j.jmig.2011.12.014
PubMed Abstract
PMID: 22285676
