Native tissue repair of cardinal/uterosacral ligaments cures overactive bladder and prolapse, but only in pre-menopausal women
| Autor: | G V Kovalev, Dmitry Shkarupa, Nikita Kubin, Ekaterina Shapovalova, A. Zaytseva |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Integral Theory
medicine.medical_specialty Pelvic organ Original Paper genetic structures surgical reconstruction of the pelvic floor business.industry Uterosacral ligament Urology General Medicine urologic and male genital diseases medicine.disease pelvic organ prolapse uterosacral-cardinal ligament complex female genital diseases and pregnancy complications body regions medicine.anatomical_structure Overactive bladder Pre menopausal Native tissue Medicine overactive bladder business ligamentoplasty |
| Zdroj: | Central European Journal of Urology |
| ISSN: | 2080-4873 2080-4806 |
| Popis: | Introduction The aim of this article was to study the effect of native tissue cardinal/uterosacral ligament repair on overactive bladder (OAB) and pelvic organ prolapse (POP). Material and methods Inclusion criteria included decrease of urge symptoms following insertion of a gauze tampon in the posterior fornix of vagina (‘simulated operation’). Exclusion criteria included SUI, POP grades 3–4. The surgery consisted of plication of cardinal/uterosacral ligaments. Post-operative assessment was performed at3, 6, 12 and 18 months after surgery and included evaluation by stage of prolapse, Urinary Distress Inventory Short Form 6 (UDI-6), Overactive Bladder Questionnaire (OAB-q), Pelvic Floor Impact Questionnaire- Short Form 7 (PFIQ-7), and International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-SF) questionnaires and voiding diary. Results At 3 months, cure rates for frequency, urgency, nocturia and prolapse were comparable. By the 6-month review, catastrophic failure commenced in the postmenopausal group, parallel for all pa-rameters, starkly contrasting with premenopausal group. At 18 months, % cure rates for pre-menopausal (post-menopausal in brackets) were 79.6 (15.4) for POP, 67.3 (20.5) for urgency, 87.7 (20.5) for nocturia and 59.2 (15.4) for frequency. Conclusions We hypothesize the stepwise parallel recurrence of POP and symptoms in the menopausal group was a consequence of collagen deficiency in the plicated ligaments. Nevertheless, plication of uterosacral-cardinal ligament complex is simple, inexpensive, effective, especially applicable pre-menopausally for POP and as an alternative treatment option in that difficult group of pre-menopausal women who have major OAB/nocturia symptoms but only minimal prolapse. |
| Databáze: | OpenAIRE |
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