Surgical Management of Pelvic Organ Prolapse in Ethiopian Women: What Is the Preferred Approach?
| Autor: | W. Thomas Gregory, Melaku Abreha, Rahel Nardos, Kyle D. Hart, Kimberly A. Kenne |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Reoperation medicine.medical_specialty Demographics Urology Population 030232 urology & nephrology Pelvic Organ Prolapse Cohort Studies 03 medical and health sciences Gynecologic Surgical Procedures Postoperative Complications 0302 clinical medicine Recurrence medicine Humans Mesh erosion Practice Patterns Physicians' Stage (cooking) Prospective cohort study education Surgical repair Pelvic organ education.field_of_study 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Middle Aged Surgical Mesh Vaginal repair Surgery Outcome and Process Assessment Health Care Female Laparoscopy Ethiopia business |
| Zdroj: | Female Pelvic Medicine & Reconstructive Surgery. 26:e7-e12 |
| ISSN: | 2151-8378 |
| DOI: | 10.1097/spv.0000000000000836 |
| Popis: | OBJECTIVES The aim of this study was to determine the most effective approach to surgical repair of pelvic organ prolapse for Ethiopian women and to characterize this population. METHODS This is a prospective cohort study of women presenting for prolapse repair. Demographics and assessments of prolapse were obtained preoperatively. Information surrounding the surgical encounter was collected. The same anatomic and symptomatic measures were ascertained postoperatively. Information regarding surgical complications was collected. RESULTS Two hundred thirty-three women with stage III or IV prolapse underwent surgical prolapse repair between March 2015 and November 2017. Seventy-eight of these women participated with a median length of follow-up of 255 days. All of the sacrocolpopexy patients (n = 21) and 56 of 57 vaginal repair patients had follow-up anatomic data. Anatomic failure as defined by Pelvic Organ Prolapse-Quantification (Ba, C, or Bp > 0) occurred in 0% (0/21) of sacrocolpopexy patients and 34% (19/56) of vaginal repair patients (P = 0.005). Symptomatic failure, as defined by self-reported recurrence of vaginal bulge, occurred in 0% (0/21) of sacrocolpopexy patients and 23% (13/56) of vaginal repair patients (P = 0.015). A global assessment of improvement (worse, same, or improved) revealed that 100% (21/21) of sacrocolpopexy patients reported improvement, whereas 91% (50/55) of vaginal repair patients reported improvement, 7% (4/55) reported being the same, and 2% (1/55) reported being worse. There were 2 intraoperative complications and 3 postoperative complications. There were no cases of mesh erosion. CONCLUSIONS Although both vaginal and abdominal routes of prolapse surgery seem to be safe, an abdominal approach with mesh augmentation may be the preferred surgical repair in Ethiopian women. |
| Databáze: | OpenAIRE |
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