Анатомічні та функціональні результати після хірургічного лікування поєднаної лейоміоми матки з генітальним пролапсом

Abstract

More than 41% of women aged 50-79 suffer from pelvic organ prolapse. Genital prolapse is combined with uterine leiomyoma in approximately 20% of cases, which necessitates a differentiated approach to the treatment. Purpose - to compare the anatomical and functional results of surgical treatment of women with uterine leiomyoma combined with genital prolapse, who underwent hysterectomy with and without prolapse correction. Materials and methods. 80 patients with genital prolapse combined with uterine leiomyoma were examined and divided into three groups. In the Control (I) Group (n=40), hysterectomy was performed without correction of genital prolapse, in the other two groups - hysterectomy and correction of genital prolapse using a mesh implant by the method of pectopexy (the Group II, n=40) or lateral fixation (the Group III, n=40). Anatomical and functional outcomes were assessed 6 and 12 months postoperatively using the POP-Q and the questionnair PFDI-20 and PISQ-12. Statistical analysis was performed with SPSS Version 21.0. Results. In women of the Groups II and III, POP-Q parameters significantly improved 6-12 months after surgery compared to the initial level, while in patients of the Group I, 1 year after surgery, negative dynamics of changes in points Aa, Ba and indicators of pb and Tvl were established. Anatomical success, which is POP-Q stage 0-1 one year after surgery and does not require further surgical treatment, was 82.5% in the Group II and 85% in the Group III. The frequency of improvement of pelvic functions according to PEDI-20 and the state of sexual function according to PISQ-12 6 months after the operation was significantly higher among women of the Groups II and III comparing to the Group I. Conclusions. The obtained data testify to the anatomical effectiveness of simultaneous hysterectomy and correction of genital prolapse using mesh implants. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.