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21.02.2017 | General Gynecology

Severe pelvic organ prolapse treated by vaginal native tissue repair: long-term analysis of outcomes in 146 patients

verfasst von: Michele Carlo Schiavi, Giorgia Perniola, Violante Di Donato, Virginia Sibilla Visentin, Flaminia Vena, Anna Di Pinto, Marzio Angelo Zullo, Marco Monti, Pierluigi Benedetti Panici

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2017

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Abstract

Aims

The aim of this study was to assess the effectiveness and safety of vaginal native tissue repair (VNTR) as a surgical treatment for severe pelvic organ prolapse (POP) and, second, to evaluate the impact on the quality-of-life (QoL) and sexual function.

Methods

Women with symptomatic POP (≥III stage according to POP Quantification System) with or without stress urinary incontinence (SUI) underwent VNTR. The clinical stage, 3-day voiding diary, and urodynamic testing were evaluated in the preoperative and postoperative times, respectively. The International Consultation on Incontinence Questionnaire–Urinary Incontinence Questionnaire Short Form (ICIQ–UI SF), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12), and the prolapse quality-of-life questionnaire (P-QoL) were administered.

Results

One hundred forty-six patients were recruited. The median follow-up was 48 months (36–63). Fifty-two women (36%) had a previous hysterectomy, and 16 (11%) had a previous prolapse/continence surgery. Preoperatively, 135 (92.5%), 109 (74.7%), and 98 (67.1%) patients had anterior, central, and posterior descent ≥III stage, respectively. Thirty-two patients (22%) had concomitant diagnosis of SUI. Median operative time was 85 min (37–154), and median postoperative hospital stay was 2 days (2–4). No intraoperative severe complications occurred. At the long-term follow-up, the subjective cure rate for prolapse was 97.3% and the objective cure rate was 91.1%. A significant improvement of ICIQ-UI SF, the P-QoL, and the PISQ-12 was recorded at the follow-up (p < 0.001).

Conclusion

VNTR is effective, safe, and durable and improves POP-related symptoms and sexual function.

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Titel: Severe pelvic organ prolapse treated by vaginal native tissue repair: long-term analysis of outcomes in 146 patients
verfasst von: Michele Carlo Schiavi
Giorgia Perniola
Violante Di Donato
Virginia Sibilla Visentin
Flaminia Vena
Anna Di Pinto
Marzio Angelo Zullo
Marco Monti
Pierluigi Benedetti Panici
Publikationsdatum: 21.02.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 4/2017
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4307-y

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Severe pelvic organ prolapse treated by vaginal native tissue repair: long-term analysis of outcomes in 146 patients

Abstract