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Prospective follow-up of women undergoing uterine-preserving surgery for symptomatic pelvic organ prolapse
Elad LERON1, Benny SHLEZINGER2, Menahem NEUMAN3, Offer EREZ1, Jacob BORNSTEIN41Department of Obstetrics and Gynecology, Soroka University Medical Center, Beersheba, Israel, 2Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel, 3Department of Urogynecology, Ben Gurion University, Beersheba, Israel, 4Department of Obstetrics and Gynecology Galilee Medical Center and Faculty of Medicine of the Bar Ilan University, Safed, Israel
Objective: Approximately 25% of all women will suffer from pelvic organ prolapse (POP), with its incidence increasing with age. Treatment includes pelvic floor physical rehabilitation, and pelvic floor surgical reconstruction. The aim of this study is to evaluate the post-surgical anatomical and functional status of the patients when presenting up to 6 months after uterine-preserving reconstructive surgeries. Materials and Methods: This prospective study included women above the age of 30, suffering from symptomatic POP who had undergone uterine-preserving vaginal approach surgery with Mesh. The Pelvic Floor Impact Questionnaire-7 (PFIQ-7) was used to assess the women’s subjective perception regarding urinary, bowel and psycho-sexual function. The questionnaire was undertaken 6 months after surgery via a telephone interview. A positive effect rate, representing an improvement in the quality-of-life following surgery, was defined as 80% of the cohort ranking ‘0’ or ‘1’ (reflecting the “no at all” to “somewhat” effects on the questionnaire) regarding a specific question about symptomatic POP. Results: The study cohort included 41 women with an average age of 66.87±10.61 years old. In 87.8% (35/41) of the patients, a posterior repair was made using a PROLIFT© mesh. In 7.5% (5/41), a posterior PROLIFT and anterior PROSIMA© were used. One patient (1/41) had an anterior and posterior repair using a PROLIFT mesh. Vaginal uterine-preserving surgery improved urinary symptoms by 58%–70%, bowel symptoms by 82.6%–92.7%, and vaginal and pelvic symptoms by 82.9%–87.8%. The success rate was higher above the age of 60. The age of the patient had a small/moderate positive correlation with urinary symptoms (p=0.416), a small positive correlation with vaginal-pelvic symptoms (p=0.367) and no correlation with bowel symptoms (p=0.149). Conclusion: Uterine-preserving surgical interventions are an effective method for treating symptomatic POP. Women undergoing reconstructive pelvic surgery reported a high post-operative resolution rate of intestinal and vaginal symptoms. Urinary symptoms are more challenging to overcome by surgical interventions.
Cite This Article
LERON E, SHLEZINGER B, NEUMAN M, EREZ O, BORNSTEIN J. Prospective follow-up of women undergoing uterine-preserving surgery for symptomatic pelvic organ prolapse. 2021; 40(4): 176-182
Corresponding Author: LERON E.
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