Роль пектопексии в коррекции цистоцеле

Abstract

Objective. To study and compare the long-term outcomes of surgical correction of cystocele with and without correction of apical prolapse by pectopexy. Design. A prospective study. Patients and methods. A total of 60 patients with cystocele stage 2 or more and apical prolapse stage 1 according to POP-Q (Pelvic Organ Prolapse Quantification System) were examined; 30 patients underwent classical anterior colpoperineorrhaphy and other 30 – combined surgeries, including anterior colporrhaphy and pectopexy. The long-term outcomes of treatment were assessed after 24 months. De novo prolapse stage 2 or more according to POP-Q was considered as prolapse recurrence. Results. The use of pectopexy in the complex surgical treatment of anterior vaginal wall prolapse combined with early stages of apical prolapse (which is not the leading point of prolapse) significantly improved long-term outcomes: 24 months after surgical treatment, cystocele stage 1 was registered only in 13.3% of cases, and 93.3% of patients had no apical prolapse. In the group of patients without pectopexy, progression of apical prolapse to stage 2 was observed in 50% of patients after 24 months. Conclusion. When planning the surgical correction of cystocele, the presence or absence of “hidden” early defects of apical support should be considered. Pectopexy in the correction of apical prolapse combined with cystocele is effective, safe, and pathogenetically sound. Its use improves the long-term outcomes of cystocele treatment and reduces the probability of recurrence. Key words: apical prolapse, long-term treatment outcomes, anterior vaginal wall prolapse, pectopexy, surgical correction, cystocele