Evaluation of three different surgical approaches in repairing paravaginal support defects: a comparative trial
| Autor: | Essam M. Khater, Wael Agur, Alaa Eldin H. El-Feky, Mohamed M. Hosni |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty Surgical approach business.industry Significant difference Obstetrics and Gynecology General Medicine Comparative trial Middle Aged Software package Surgery Gynecologic Surgical Procedures Treatment Outcome Uterine Prolapse Good evidence Vagina medicine Humans In patient Female Prospective Studies Stage (cooking) business Aged |
| Zdroj: | Archives of gynecology and obstetrics. 288(6) |
| ISSN: | 1432-0711 |
| Popis: | Paravaginal defects have been shown to account for 60–80 % of anterior compartment prolapse and its repair offers the chance of a more effective cure of such defect. There is no good evidence to suggest the superiority of a particular route of paravaginal repair. The objective of this study was to evaluate the effectiveness of abdominal (APVR), vaginal (VPVR) and laparoscopic (LPVR) approaches in the repair of such defects. This is a prospective comparative study of patients, referred over a 2-year period, with symptomatic stage II–IV anterior compartment prolapse due to paravaginal support defects. Patients were assessed subjectively by direct verbal questioning, and objectively, using POP-Q system for staging, at 1, 6 and 12 months postoperatively. Analysis of data was performed using SPSS for Windows (V9) software package. Forty-five patients were recruited to the study. There was no significant difference in the subjective and objective outcomes of APVR (n = 20) and VPVR (n = 20) groups. The laparoscopic approach had to be abandoned after five patients only, as the degree of improvement in prolapse stage was less than in the other two approaches. The effectiveness of paravaginal repair procedure is similar whether the abdominal or vaginal approaches were adopted in patients with anterior compartment prolapse due to paravaginal support defects. In our experience, the laparoscopic approach was associated with the least favourable outcome. |
| Databáze: | OpenAIRE |
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