Anatomic outcomes of sacrohysteropexy without posterior mesh placement in patients with asymptomatic grade 1 and 2 rectoceles: Is a rectouterine mesh really necessary?

Autor: Sancı A; Urology Department, Faculty of Medicine, Ankara University, Ankara, Turkey., Obaid K; Urology Department, Faculty of Medicine, Ankara University, Ankara, Turkey., Topcuoglu M; Department of Urology, Alaaddin Keykubat University Education and Research Hospital, Alanya, Turkey., Gokce Mİ; Urology Department, Faculty of Medicine, Ankara University, Ankara, Turkey., Süer E; Urology Department, Faculty of Medicine, Ankara University, Ankara, Turkey., Gülpinar Ö; Urology Department, Faculty of Medicine, Ankara University, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Lower urinary tract symptoms [Low Urin Tract Symptoms] 2023 Jul; Vol. 15 (4), pp. 122-128. Date of Electronic Publication: 2023 Mar 30.
DOI: 10.1111/luts.12479
Abstrakt: Objectives: To present the anatomic outcomes of sacrohysteropexy surgery without posterior mesh placement in patients with asymptomatic grade 1 and 2 rectoceles.
Methods: The patients who underwent abdominal sacrohysteropexy without posterior mesh placement for the treatment of symptomatic grade 3 and 4 anterior/apical prolapse + asymptomatic grade 1 and 2 rectocele between May 2015 and January 2021 were evaluated retrospectively. The success rate, the anatomic outcomes (for anterior, apical, and posterior pelvic organ prolapse [POP]), and perioperative data of the surgical procedure were assessed. The objective failure criteria after surgery included the presence of grade 1 or higher in any compartment (anatomical criteria), recurrent POP requiring an operation, and/or usage of pessaries. Perioperative adverse events were categorized according to the Clavien-Dindo classification.
Results: Fifty-one patients underwent sacrohysteropexy without posterior mesh. The mean age of the patients was 56.8 ± 10 years. The success rates (anatomical outcomes) for the anterior/apical and posterior POP in the study group were 60.7%, 54.9%, and 58.8%, respectively, at a median follow-up time of 40.24 (24-71) months. The median hospital stay was 3.1 (2-6) days. The mean estimated blood loss was 127.6 (80-150) mL. The mean operation time was 114 (90-156) min. The mean urethral and catheter removal times were 1.3 (1, 2) and 2.1 (2-4) days, respectively. The mean recovery time of gastrointestinal motility was 14.4 h (11-35).
Conclusions: Sacrohysteropexy without posterior mesh placement might be associated with less pain, shorter operative time, and shorter recovery time of gastrointestinal motility, without compromising the anatomic success.
(© 2023 John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje