Anatomic and functional results after surgical treatment of uro genital prolapse: propective study about 93 cases

##plugins.themes.academic_pro.article.sidebar##

Published Dec 19, 2011
Download
pdf
Vol. 89 No. (2011): Issue Dec 2011

##plugins.themes.academic_pro.article.main##

Nabil Mathlouthi
Jihene Elloumi
Haikel Trabelsi
Issam Ben Ali
Mohamed Dhouib
Kaies Chaabene
Habib Amouri
Belhassen Ben Ayed
Mohamed Guermazi

Abstract

Background : genital polapse is a frequent olisease several techniques were described
Aim: To evaluate the anatomical and functional results of surgery for genital prolapse by vaginal and abdominal approach.
Methods: Prospective study on 93 patients operated for urogenital prolapse (50 by high and 43 vaginal approach) in the department of obstetrics and gynecology of Sfax. Anatomic results and postoperative patient satisfaction was assessed. Quality of life was assessed using the French versions of the questionnaires Pelvic Floor Distress Inventory (PFDI 20), Pelvic Floor Impact Questionnaire (PISQ 7).
Results: The mean age of patients was 59 years. 85.9% of our population consisted of postmenopausal women. The results of the postoperative visit, after a mean of 28.7 months, showed about the anatomical level, a success rate for the treatment of prolapse by high 82% against 72.1% for vaginal delivery, but the difference is not significant (P = 0.45). For prolapse of grades 1 and 2, surgical treatment by high and low has corrected all the elements of prolapse.
For prolapse of grades 3 and 4, high surgery has resulted in a satisfactory anatomical result in 86%, while the lower channel yielded a significant result in 76.5%, and recurrence were interested mainly the anterior stage. The questionneer PFDI 20, showed an improvement in the quality of life after surgery significantly in both
groups (p<0.003). The improvement was more significant PFDI 20 after surgery by high versus vaginal surgery (p <0.002). Regarding PFIQ 7, improved quality of life was observed after surgery without significant differences between the two groups.
Conclusion: The treatment of urogenital prolapse is mainly based on surgical and reconstructive surgery to restore anatomical and functional surgery also in order to improve the quality of life of patients.

Keywords:

Urogenital prolapse, Stress urinary incontinence, Anatomic results, Functional results.

##plugins.themes.academic_pro.article.details##

References

  1. Wiskind AK, Creighton SM, Stanton SL. The incidence of genital prolapse after the burch colposuspension. Am J Obstet Gynecol 1992; 167: 399-404.
  2. Matsuyama H, Hirata H, Tomimatsu T, Naito K. Follow up of surgical repair of female pelvic floor disorders by a mailed questionnaire. Int J Urol 2006;13: 389-94;
  3. Barber MD, Kuchibhatla MN, Pieper CF, Bump RC. Psychometric evaluation of 2 comprehensive condition -specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 2001; 185:1388-95.
  4. De Tayrac R, Deval B, Fernandez H, Mres P et Mapi Research Institute. Validation linguistique en français des versions courtes des questionnaires de symptômes (PFDI 20) et de la qualité de vie (PFIQ 7) chez les patientes présentant un trouble de la statique pelvienne. J Gynecol Obstet Biol Reprod 2007;5 : 34-41.
  5. Bradley CS, Kennedy CM, Nygaard IE. Pelvic floor symptoms and lifestyle factors in older women. J Womens Health 2005;14:128-36.
  6. Wyman JF. The psychiatric and emotional impact of female pelvic floor dysfunction. Curr Opin Obstet Gynecol 1994; 6:336-9.
  7. Fitzgerald MP, Kenton K, Shott S, Brubaker L. Responsiveness of quality of life measurements to change after reconstructive pelvic surgery. Am J Obstet Gynecol 2001;185:20-4.
  8. Kdous K, Zhioua F. La prothèse sous vésicale transobturatrice:tolérance et résultats à moyen terme. Etude prospective à propos de 45 cas. J Gynecol Obstet Biol Reprod 2008 ;37: 758-69.
  9. Bouchet P, Crenn D, Deleflie M et al. Retentissement de la chirurgie du prolapsus genital sur la sexualité des patientes. Gynecol Obstet Fertil 2010; 38 :373-79.
  10. Maher C, Baessler K, Glazner CMA, Adams EJ. Surgical management of pelvic organ prolapse in women. Cochrane Data Bas Syst Rev 2004;4:401-4.
  11. C. Bui, M. Ballester, E. Chereau, E. Guillo, E. Dara›. Résultats fonctionneels et qualité de vie après double promontofixation coelioscopique pour la cure du prolapsus génital. Gynecol Obstet Fertil 2010;38: 563-68.
  12. Helstrom L, Nilsson B. Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus. Acta Obstet Gynecol Scand 2005; 84: 79-84.
  13. Daraݬ E, Coutant C, Rouzier R, Ballester M, David-Montefiore E, Apfelbaum D. Genital prolapse repair using porcine skin implant and bilateral sacrospinous fixation: midterm functional outcome and quality-of-life assessment. Urology 2009;73: 245-50.
  14. David-Montefiore E, Barranger E, Dubernard G, Nizard V, Antoine JM, Daraݬ E. Functional results and quality of-life after bilateral sacrospinous ligament fixation for genital prolapse. Eur J Obstet Gynecol Reprod Biol 2007;132: 209-13.