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The effect of surgical plication of uterosacral ligament to rectovaginal fascia on lower urinary tract symptoms in patients with posteroapical compartment defect
İsmail GÖKBEL1, Deniz AKIN GÖKBEL2, Mehmet Ferdi KINCI2, Burak SEZGİN2, Ahmet Akın SİVASLIOĞLU21Department of Obstetrics and Gynecology, Menteşe State Hospital, Muğla, Turkey, 2Department of Obstetrics and Gynecology, Muğla Sıtkı Koçman University Training and Research Hospital, Muğla, Turkey
Objectives: A competent rectovaginal fascia (RVF) and uterosacral ligaments (USL) are required to provide active and passive structural support to rectum and vagina. We aimed to reveal the effect of the anatomical improvement provided by plication surgery of RVF to USLs on the lower urinary tract symptoms (LUTS) in the posteroapical compartment defect. Materials and Methods: This prospective study was carried out with patients who applied to the Urogynecology Polyclinic of Muğla Sıtkı Koçman University, Department of Obstetrics and Gynecology between August 2018 and March 2020. Patients with POP stage >1 and posteroapical compartment defects were included in the study. In the preoperative and postoperative periods (3rd, 6th, and 12th months), the lower urinary system symptoms of the patients were questioned and the Pelvic Organ Prolapse Quantification (POP-Q) scoring system was evaluated and were compared. Results: Of the patients included in the study, 42 (82.35%) were multiparous, 7 (13.72%) were primiparous, and 2 (3.92%) were nulliparous. Statistically significant improvements were observed in lower urinary symptoms in the postoperative 3rd, 6th, and 12th month controls (p<0.05), while there were significant improvements in Aa, Ba, C, D, Ap, Bp, Pb, and TVL scores in the postoperative period (p<0.05). Conclusion: Based on the results of this native tissue surgery; the suturing of RVF to USLs for posteroapical compartment defect seems an effective surgical intervention with satisfactory anatomical and symptomatic outcomes.
Cite This Article
GÖKBEL İ, AKIN GÖKBEL D, KINCI M, SEZGİN B, SİVASLIOĞLU A. The effect of surgical plication of uterosacral ligament to rectovaginal fascia on lower urinary tract symptoms in patients with posteroapical compartment defect. 2022; 41(1): 39-45
Corresponding Author: GÖKBEL İ.
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