The resurrection of sacrospinous fixation: unilateral apical sling hysteropexy
| Autor: | Nikita Kubin, Dmitry Shkarupa, Ekaterina Shapovalova, Anastasya Zaytseva |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pelvic pain syndrome
medicine.medical_specialty Sling (implant) Urology medicine.medical_treatment Operative Time Paraspinal Muscles 030232 urology & nephrology Rectum Apical compartment Colpotomy Pelvic Organ Prolapse Colporrhaphy 03 medical and health sciences 0302 clinical medicine medicine Humans Postoperative Period Prospective Studies Aged High rate Suburethral Slings Ligaments 030219 obstetrics & reproductive medicine business.industry Uterus Obstetrics and Gynecology Chronic pain syndrome Middle Aged Surgical Mesh medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Patient Satisfaction Sacrospinous fixation Female business |
| Zdroj: | International Urogynecology Journal. 31:351-357 |
| ISSN: | 1433-3023 0937-3462 |
| Popis: | The apical compartment is a keystone in POP treatment. Sacrospinous fixation, suggested half a century ago, today is still one of the most popular and efficient methods of colpo-hysteropexy. However, it has specific side effects: chronic pain syndrome, dyspareunia and а high rate of cystocele de novo. We aimed to evaluate the efficacy and safety of unilateral sacrospinous hysteropexy with a synthetic apical sling combined with anterior subfascial colporrhaphy. Following the suggested technique, 174 women with anterior-apical prolapse underwent surgery. The follow-up period took 12 months. Pre- and postoperative examination included: urogynecological examination (POP-Q), uroflowmetry, ultrasound of the bladder and filling in of validated questionnaires (PFDI-20, PISQ-12). The mean surgery time was 26 ± 7.84 min. No cases of damage of the bladder or rectum or of intraoperative clinically significant bleeding were noted. At the 12-month follow-up, the recurrence rate in the apical compartment was 0.7% (1/147) and in the anterior compartment 7.4% (11/147). The efficacy of the surgery reached 96.5%. During 12 months of follow-up, no cases of mesh exposure or chronic pelvic pain syndrome were detected. The incidence of dyspareunia de novo was observed in just one patient. A unilateral sacrospinous fixation with a synthetic mesh (apical sling) combined with anterior subfascial colporrhaphy enhances the anatomical efficacy of surgery. It also helps to avoid specific side effects of traditional sacrospinous fixation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink