660 Pelvic organ prolapse: what can we do?

Abstract

ObjectivePelvic organ prolapse (POP) significantly reduces the women‘s life quality due to urinary difficulty, sexual dysfunction, depression and social exclusion. Every third woman in Ukraine has pelvic disorders due to organ prolapse, which requires surgery, that isn‘t always effective, especially in the elderly. The aim of the study was to optimize of pelvic organ prolapse‘s surgical procedures in elderly women. Methods: 85 elderly women with apical prolapse and presence of defect in the anterior and posterior compartments of 3-4 centuries were examined, 30 women without signs of POP formed a control group. To grade the stage of prolapse, Organ Prolapse Quantitation system (POPQ) (1996) was used. Treatment of genital prolapse in the first group (45 women) included vaginal hysterectomy without oophorectomy, colpocleisis, with unilateral sacspinic colpopexy. Second group (40 women) was treated by vaginal hysterectomy without oophorectomy, colpocleisis without unilateral sacspinic colpopexy. Results: In the first group, one relapse (2.2%) was observed - complete procidentia of the vaginal wall after 6 months with urinary disfunction, without defecatory problems in the woman, which had postoperative complications (prolonged temperature increasing). One woman (2.2%) had a slight vaginal wall prolapse after one year without pelvic dysfunction. In the second group, complications were observed in 7 women (17.5%): 3 women (7.5%) had a complete procidentia with pelvic dysfunction, a slight prolapse without pelvic dysfunction - in 4 women (10%). Conclusions: Unilateral sacspinal colpopexy in the surgical treatment of women with POP significantly reduces the risk of relapse and improves the women‘s life quality.