Surgical Updates in the Treatment of Pelvic Organ Prolapse

Geynisman‐Tan, Julia; Kenton, Kimberly

doi:10.5041/rmmj.10294

Cited by 24 publications

(9 citation statements)

References 85 publications

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“…Recent RCOG guideline concluded that," colposuspension at the time of sacrocolpopexy is an effective measure to reduce postoperative symptomatic SUI in previous continent women; however colposuspension at time of ASC for overt SUI does not appear to be effective" [3] . Concomitant repair of the anterior or posterior compartment is not required if apical repair is performed meticulously with extension of mesh to the anterior and posterior vagina [17,21] . We followed up our patients at 6 weeks, 6 months and 1 year of surgery to check for any complaints, recurrence of prolapse by POP-Q staging (stage II or more), urinary symptoms, constipation, dyspareunia, back pain and vaginal discharge.…”

Section: Discussionmentioning

confidence: 99%

Sacrocolpopexy for post hysterectomy vault prolapse: A single centre experience in south India

Mohapatra¹,

Samantaray²

2021

Int. J. Clin. Obstet. Gynaecol.

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Post hysterectomy vault prolapse is the protrusion of vagina through the genital hiatus and is sometimes accompanied by bowel and bladder symptoms. Sacrocolpopexy is considered as the gold standard for surgical management of vaginal vault prolapse. This procedure can be performed by abdominal, laparoscopic or robotic route. In this study we are presenting the analysis of all the cases of vault prolapse managed by abdominal or laparoscopic sacrocolpopexy in our hospital within a period of four years and its outcome until a follow up for one year. The majorities of the patients in our case series presented with a reducible vaginal mass and most of them had POP-Q stage III prolapse. Abdominal sacrocolpopexy and laparoscopic sacrocolpopexy was performed for seven and five cases respectively. Anatomic success rate was 100% and none of them had a recurrence of apical prolapse till one year of follow up. Immediate improvement of symptoms was observed in 86% and 100% of patients with ASC and LSC respectively; but at one year of follow up the functional improvement were retained in 57% and 80% for ASC and LSC respectively. Sacrocolpopexy is a reliable & effective procedure for management of vaginal vault prolapse. This procedure provides relief from the symptoms of prolapse along with providing good anatomical support and is helpful in preventing recurrence of the defect.

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Section: Discussionmentioning

confidence: 99%

Sacrocolpopexy for post hysterectomy vault prolapse: A single centre experience in south India

Mohapatra¹,

Samantaray²

2021

Int. J. Clin. Obstet. Gynaecol.

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“…It is possible to correct this defect with purse-string and reinforced sutures resulting in no recurrences and no postoperative voiding complications [6]. Given that many failures of anterior vaginal repairs are due to the weakness of vaginal apical supports [9], the success rates for cystocele repair may be improved by performing a concomitant apical procedure, such as the uterosacral or sacrospinous ligament suspension [4,10,11]. The low recurrence rate observed with the surgical method described here may be due to the combination of both pubocervical fascia repair and uterosacral ligament suspension.…”

Section: Discusionmentioning

confidence: 99%

Short term outcomes of a new non-dissection minimally invasive surgery method for cystocele repair

Calongos,

Tsuji,

Ito

et al. 2020

Clin. Exp. Obstet. Gynecol.

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Purpose of investigation:The objective of this study was to assess the safety and efficacy of our new surgical technique for cystocele treatment. Materials and Methods: Twenty patients diagnosed from May 2017 to October 2018 with a minimum stage III cystocele were included. Our new technique was performed bilaterally using two polypropylene monofilament suture threads. The suture started at the level of the left bulbo cavernosus muscle and continued to the right and then to the left uterosacral ligament. With the second thread, the suture was made on the opposite side to that described above. Patients were followed-up for a minimum of six months post-operatively (mean 9.9 months). Results: No intra-surgical or post-surgical complications were observed. Only one patient presented with a cystocele recurrence during follow-up, but did not require treatment. Conclusion: The new surgical technique was found to be safe and effective for cystocele repair in this study.

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“…It is estimated that two out of three parous women have anatomical evidence of POP in midlife [3]. Furthermore, it is expected that prevalence will increase by nearly 50 % in the next 40 years [4,5]. Sacrocolpopexy (SC) is considered the preferred treatment for vaginal vault prolapse [6], with good (82.5 %) long-term subjective success rates [7].…”

Section: Introductionmentioning

confidence: 99%

A uniaxial force and stiffness model of the vagina during laparoscopic sacrocolpopexy

Smet

Page

Deprest

et al. 2021

Clinical Biomechanics

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Background: Laparoscopic sacrocolpopexy is the preferred procedure for restoring vaginal vault prolapse. An assistant uses a vaginal manipulator to position and tension the vault such that the surgeon can dissect the bladder, rectum and vault to eventually suture a synthetic mesh used to suspend the vagina to the longitudinal anterior vertebral ligament. Vaginal vault manipulation requires application of high forces for long periods of time.Methods: This work quantifies the task by measuring and analyzing the interaction forces and the workspace during vaginal vault manipulation. From the measurements we developed a uniaxial model, expressing the increase in interaction force and stiffness of the vagina. By adapting the model parameters, the difference in interaction force and stiffness between moderate and severe prolapse are predicted.Findings: For moderate prolapse the average interaction force and stiffness start at 2.56 N and 0.11 N mm −1 in the tensionfree state, and go up to 20.14 N and 0.53 N mm −1 after complete insertion of the instrument. For severe degrees of prolapse, tissue interaction is much lower starting at 1.68 N and 0.06 N mm −1 while staying limited to 12.20 N and 0.30 N mm −1 at full extension.

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Surgical Updates in the Treatment of Pelvic Organ Prolapse

Cited by 24 publications

References 85 publications

Sacrocolpopexy for post hysterectomy vault prolapse: A single centre experience in south India

Sacrocolpopexy for post hysterectomy vault prolapse: A single centre experience in south India

Short term outcomes of a new non-dissection minimally invasive surgery method for cystocele repair

A uniaxial force and stiffness model of the vagina during laparoscopic sacrocolpopexy

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