The age distribution, rates, and types of surgery for pelvic organ prolapse in the USA

Shah, Aparna D.; Kohli, Neeraj; Rajan, Sujatha S.; Hoyte, Lennox

doi:10.1007/s00192-007-0457-y

Cited by 129 publications

(64 citation statements)

References 20 publications

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“…Anterior colporrhaphy is one of the standard techniques for anterior vaginal prolapse and is the single most common procedure for POP repair [14]. Because the risk of recurrence is as high as 40% [15], using mesh implants has been of great interest to urogynecologists who manage POP since it was first described in 1996 [16].…”

Section: Discussionmentioning

confidence: 99%

Changes in Urinary and Sexual Function 6 Months after Cystocele Repair with a Polypropylene Mesh

Lee¹,

Park

Choe³

et al. 2012

Urol Int

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Introduction: We used quantitative parameters obtained during the voiding phase, urinary symptoms and sexual functioning to investigate the symptomatic and functional changes after cystocele repair with a polypropylene mesh. Patients and Methods: The maximum urinary flow rate (Q_max), residual urine (RU) volume and two symptom questionnaires, the Urinary Distress Inventory (UDI-6) and the Female Sexual Function Index (FSFI), were used to retrospectively evaluate 39 consecutive cystocele patients before and 6 months after surgery. Results: Q_max, RU and FSFI were not significantly different (p = 0.366, 0.286 and 0.100, respectively) pre- and postoperatively, but the UDI-6 score had significantly improved (p < 0.001) 6 months after the cystocele repair. A concomitant sling procedure was significantly correlated with changes in the UDI-6 score (p < 0.001); the patients without stress urinary incontinence (SUI) who underwent cystocele repair only showed no symptomatic improvements in the UDI-6 score (p = 0.560). Conclusions: Correction of SUI resulted in urinary symptom improvement in cystocele patients. Cystocele repair with or without sling placement did not change Q_max, RU or sexual functioning at the 6-month follow-up.

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Section: Discussionmentioning

confidence: 99%

Changes in Urinary and Sexual Function 6 Months after Cystocele Repair with a Polypropylene Mesh

Lee¹,

Park

Choe³

et al. 2012

Urol Int

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“…Recent research demonstrates that women undergoing prolapse surgery have a prevalence of concomitant hysterectomy and anti-incontinence surgery of 44% and 35.1%, respectively. 3 Our study was a randomised controlled trial. 2 The major advantage of randomisation is to control for potential confounding, with the randomisation processes evenly distributing confounders among the two treatment groups.…”

Section: Authors' Replymentioning

confidence: 99%

Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial

Poulose

Saha

2010

BJOG

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Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial Sir, We appreciate the contribution of Carey et al.1 in the debate on the usefulness of mesh in the surgical management of vaginal prolapse. The study would have been of greater relevance had the authors solely compared traditional repair and mesh repair for vaginal prolapse. In the above study, many women had additional procedures, such as vaginal hysterectomy and repair of stress incontinence, which, by themselves, could have affected the outcomes.A larger homogeneous study population, preferably in the multicentre setting, is recommended for future studies on the optimum surgery for vaginal prolapse.As the success of interventions and their complication rates are operator dependent, the results of future evaluations should ideally be stratified by operator experience.In addition, studies need to be instituted on the optimum operative modalities for primary and subsequent repairs. Attention is also required for the evaluation of long-term postoperative outcomes. These systematic studies would help address issues on the optimum use of mesh and operators' training and mentoring needs. j Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial Authors' ReplySir, We thank Poulose and Saha for their comments. 1 When designing our study, 2 we deliberately chose to include women scheduled for a vaginal hysterectomy and antiincontinence surgery in order to improve the generalisability of the study. Recent research demonstrates that women undergoing prolapse surgery have a prevalence of concomitant hysterectomy and anti-incontinence surgery of 44% and 35.1%, respectively. Our study was a randomised controlled trial.2 The major advantage of randomisation is to control for potential confounding, with the randomisation processes evenly distributing confounders among the two treatment groups.We agree that long-term evaluation of outcomes is important. We are currently undertaking the long-term follow-up of study subjects. j

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“…Epidemiyolojik çalışmalara göre pelvik organ prolapsusu veya inkontinans nedeniyle hayat boyu operasyon olma riskini %7-9 olarak rapor edilmiştir (1,2). Anterior kolporafi, yani sistosel tamiri, bu operasyonaların en sık yapılanıdır (3). Sistosel, anterior vajinal duvarın mesanenin herniasyonu ile birlikte sarkması olarak tanımlanır (4).…”

Section: Introductionunclassified

Anterior Colporrhaphy Technique and Approach Choices: Turkey Evaluation

Aydın¹,

Bakar²,

Batmaz³

et al. 2016

Haseki

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ÖzAmaç: Türkiye'de anterior vajinal duvar cerrahisi ile ilgilenen cerrahlar arasındaki anterior kolporafi tekniklerindeki ve yaklaşımlarındaki farklılıkları değerlendirmektir. Yöntemler: Preoperatif muayeneyi, anterior kolporafi tekniğini, operasyon tercihlerini ve postoperatif bakımı değerlendiren anket cerrahlara sunuldu. Direkt olarak, elektronik posta, telefon veya anlık mesajlaşma ile iletişime geçildi. Yirmi sekiz soruluk anketi kullandık. Data analizi yapıldı ve frekanslar hesaplandı. Bulgular: Anketi tamamlayan 116 kişi vardı. Büyük bir kısmını (%87,9) genç jinekologlar oluşturuyordu. Ürologlar çalışma popülasyonunun %9,5'ini oluşturuyordu. Paravajinal defekti değerlendirme oranı %75,9'du ve çoğunlukla rugaların izlenmesi ile değerlendiriliyordu. Transperineal 3D pelvik taban ultrasonografi kullanımı düşüktü (%5,7). Levator ani kas hasarını değerlendirme oranı %46,6 idi. Levator ani kas defekti için transperineal ultrasonografi kullananlar cerrahlar %19'du. Hidrodiseksiyon kullanımı, fasya plikasyonu, fazlalık vajina mukozasının çıkartılması ve sütur tercihleri konusunda farklılıklar mevcuttu. Anterior kolporafi için meş kullanımı nadir (%17,8) olup, çoğunlukla (%12,2) nüks olgularında kullanılıyordu. Paravajinal defekt onarımı yapanlar anketi cevaplayanlar içinde %31,9'du. Üriner kateter genellikle birinci veya ikinci gün çıkartılıyordu. Vajinal tampon genellikle operasyondan 24 saat sonra çıkartılıyordu. Sonuç:Türkiye'deki operatörler arasında anterior vajinal duvar onarımı teknikleri ve yaklaşımları çeşitlilik göstermektedir. Teknikler arasındaki bu farklılıklar en iyi cerrahi teknik konusunda fikir birliği olmadığını düşündürmektedir. Teşhis için kullanılan teknolojinin gelişimi ile birlikte operasyon seçenekleri de değişebilir. Anahtar Sözcükler: Kolporafi anterior, anterior vajinal duvar prolapsusu, sistosel, meş, paravajinal defekt onarımı Aim: To evaluate the diversity in techniques and approaches for anterior colporrhaphy among operators in Turkey. Methods:A survey evaluating the preoperative examination, technique of anterior colporrhaphy, operation choice and postoperative care was presented to surgeons. We contacted via directly, mail or telephone. We used 28 item questionnaire.Results: Majority (87.9%) was composed of young gynecologists. Urologists composed of the 9.5% of the study population. The rate of paravaginal defect evaluation was 75.9% and mostly by inspection the presence of vaginal rugae. The use of transperineal 3D pelvic floor ultrasonography was low (5.7%). The evaluation of levator ani muscle defect was 46.6%. The usage of the transperineal 3D ultrasonography for levator ani muscle defect was 19 percent of operators. There were diversity in use of hydrodissection, fascial plication, excision of vaginal mucosa and suture choice. Usage of mesh for anterior colporrhaphy was limited (17.8%) and mostly in recurrent cases (12.2%). Paravaginal defect repair rate was 31.9%. The urinary catheter was generally removed one or two day after operation. Vaginal pack usually removed 24 hour...

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The age distribution, rates, and types of surgery for pelvic organ prolapse in the USA

Cited by 129 publications

References 20 publications

Changes in Urinary and Sexual Function 6 Months after Cystocele Repair with a Polypropylene Mesh

Changes in Urinary and Sexual Function 6 Months after Cystocele Repair with a Polypropylene Mesh

Vaginal repair with mesh versus colporrhaphy for prolapse: a randomised controlled trial

Anterior Colporrhaphy Technique and Approach Choices: Turkey Evaluation

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