Anchorless implant for the treatment of advanced anterior and apical vaginal prolapse – Medium term follow up
| Autor: | Mauro Cervigni, Anat Beck, Naama Marcus, Zoltan A. Fekete, Anna Padoa, Gil Levy |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Urinary incontinence Pelvic Pain Medium term Prosthesis Implantation Gynecologic Surgical Procedures Postoperative Complications Blood loss Recurrence Uterine Prolapse medicine Humans Prospective cohort study Aged Pelvic organ business.industry Pelvic pain Obstetrics and Gynecology Middle Aged Surgical Mesh Surgery Polypropylene mesh Treatment Outcome Reproductive Medicine Quality of Life Female Implant Chronic Pain medicine.symptom business |
| Zdroj: | European Journal of Obstetrics & Gynecology and Reproductive Biology. 246:55-59 |
| ISSN: | 0301-2115 |
| Popis: | Objective to evaluate the mid-term safety and efficacy of a surgical technique using an anchorless implant. Study design This is a prospective study. Women with symptomatic POP were recruited. The technique involved placement of an open trapezoid-shaped frame which retains a polypropylene mesh stretched within its parameter. No fixation techniques used. Demographic data and pre-operative quality of life (QoL) questionnaires were collected. Peri-operative data were documented. Patients were followed at 2, 6, 12, 24 and 36 months. Follow-up included repeated QoL questionnaires, Pelvic Organ Prolapse- Quantification (POP-Q) measurements and assessment for possible complications. Results Seventy women were recruited. Mean age was 63.1 years, mean parity was 4.6 deliveries. Mean pre-operative POP-Q were Ba = 3.1 (-1 to 6) cm and C = 0.4 (-8 to 6) cm. No intra-operative complications were observed. Surgical time averaged 24.7 min. Estimated blood loss averaged 155 cc. Mean follow up at last visit was 27.7 months. Two patients (2.8 %) underwent partial frame resection and two patients (2.8 %) underwent a TVT-O for de-novo stress urinary incontinence (SUI). At follow-up, the mean POP-Q were Ba= -2.8 (-3 to -1) cm and C = -6.8 (-10 to 1) cm. Two patients (2.8 %) had recurrent prolapse. One was symptomatic and received treatment. No mesh erosion or chronic pelvic pain were documented. Pelvic Function Distress Inventory (PFDI20) scores showed significant improvement. Thirty-eight (54 %) patients completed the Pelvic organ prolapse/Urinary Incontinence Sexual Questionnaire (PISQ12) showing no chronic dyspareunia. Conclusion The Self Retaining Support (SRS) implant provides 97 % subjective and 94.3 % objective cure. Two patients (2.8 %) had the implant’s frame removed surgically. The SRS is a safe and effective treatment for pelvic organ prolapse. |
| Databáze: | OpenAIRE |
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