Yonsei Med J.  2005 Feb;46(1):112-118. 10.3349/ymj.2005.46.1.112.

A Comparison of Different Pelvic Reconstruction Surgeries Using Mesh for Pelvic Organ Prolapse Patients

• Bai SW
• Kim EH
• Shin JS
• Kwang S
• Park KH
• Lee DH

• KMID: 2158120
• DOI: http://doi.org/10.3349/ymj.2005.46.1.112

Abstract

This study was carried out in order to compare the effects in different surgeries using mesh in pelvic organ prolapse patients whose leading points were C. Thirty-nine patients were categorized into 3 groups: group A pelvic reconstruction with hysterectomy; group B hysterectomy prior to pelvic reconstruction; and group C pelvic reconstruction with uterus preserved. At first visit, POP-Q stage was determined, and age, BMI, admission days, operation time, post-operative stage and complications were observed and results were analyzed and compared. All patients who were operated upon converted to stage one month following the operation, and no further change was observed except in one patient. Group admission days were not significantly different, but tended to be lower in group C. Group average operation times between 'group A and B' and 'group A and C' were statistically different. No significant difference was observed in post-operative complications between the groups, but 3 members of group A developed erosion, whereas no erosion occurred in groups B and C. Pelvic reconstruction using mesh is a highly efficient method of treating pelvic organ prolapse. Improvements in stage and post-operative complications were not significantly different in the groups. However, uteropexy showed a shorter operation time, fewer admission days, and less erosion due to mesh than conventional pelvic reconstruction with hysterectomy.

Keyword

Pelvic organ prolapse; pelvic reconstruction; mesh

MeSH Terms

Adult
Aged
Aged, 80 and over
Comparative Study
Female
Humans
Middle Aged
Pelvis/surgery
Reconstructive Surgical Procedures/*methods
Retrospective Studies
*Surgical Mesh
Uterine Prolapse/*surgery
Visceral Prolapse/*surgery

Reference

1. Bai SW. Clinical evaluation of Pelvic Organ Prolapse (POP). Korean Urogynecol J. 1999. 1:66–71.

2. Costantini E, Lombi R, Micheli C, Parziani S, Porena M. Colposacropexy with Gore-Tex mesh in marked vaginal and uterovaginal prolapse. Eur Urol. 1998. 34:111–117.

3. Beck RP. Kase NG, Weingold AB, editors. Pelvic relaxational prolapse. Principles and practice of clinical gynecology. 1983. New York: John Wiley & Sons;677–685.

4. Olsen AL, Smith VG, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997. 89:501–506.

5. Kim JH. Non-surgical treatment of stress urinary incontinence. Korean Urogynecol J. 1999. 1:72–77.

6. Parker G, Nicolas DH. Genital prolapse. Uterus Pathology, Diagnosis and Management by Albert Altcheck Liane Deligdirch. 1991. New York: Springer-verlag;368–387.

7. Cruikshank SM, Cox DW. Sacrospinous fixation at the time of transvaginal hysterectomy. Am J Obstet Gynecol. 1990. 162:1611–1619.

8. Lefranc JP, Atallah D, Camatte S, Blondon J. Longterm followup of posthysterectomy vaginal vault prolapse abdominal repair: A Report of 85 cases. J Am Coll Surg. 2002. 195:352–358.

9. Birch C, Fynes MM. The role of synthetic and biological prostheses in reconstructive pelvic floor surgery. Curr Opin Obstet Gynecol. 2002. 14:527–535.

10. Leron E, Stanton SL. Sacrohysteropexy with synthetic mesh for management of uterovaginal prolapse. BJOG. 2001. 108:629–633.

11. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996. 175:10–17.

12. Shull BL, Capen CV, Riggs MW, Kuehl TJ. Preoperative and postoperative analysis of site-specific pelvic support defects in 81 women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol. 1992. 166:1764–1771.

13. Toglia M, DeLancy JO. Anal incontinence and the obstetrician gynecologist. Obstet Gynecol. 1994. 94:731–734.

14. Poma PA. Nonsurgical management of genital prolapse. A review and recommendations for clinical practice. J Reprod Med. 2000. 45:789–797.

15. Singh K, Reid WM. Non-surgical treatment of uterovaginal prolapse using double vaginal rings. BJOG. 2001. 108:112–113.

16. Nezha CH, Nezhat F, Netzhat C. Laparoscopic sacral colpopexy for vaginal vault prolapse. Obstet Gynecol. 1994. 84:885–888.

17. Valaitis SR, Stanton SL. Sacrocolpopexy: a retrospective study of a clinician's experience. Br J Obstet Gynaecol. 1994. 101:518–522.

18. Podratz KC, Ferguson LK, Hoverman VR. Abdominal sacral colpopexy for posthysterectomy vaginal vault descendus. J Pelvic Sur. 1995. 1:18–25.

19. Kohli N, Walsh PM, Roat TW, Karram MM. Mesh erosion after abdominal sacrocolpopexy. Obstet Gynecol. 1998. 92:999–1004.

20. Banu LF. Synthetic sling for genital prolapse in young women. Int J Gynaecol Obstet. 1997. 57:57–64.