Anterior abdominal fixation - a new option in the surgical treatment of pelvic organ prolapse.

Abstract

To present anterior abdominal fixation - a new surgical technique for the treatment of pelvic organ prolaps (POP) and to evaluate the results of the treatment of patients with stage III and IV POP operated using this technique. Anterior abdominal fixation for treating stage III and IV POP was carried out in 42 women, who were qualified according to the Pelvic Organ Prolapse Quantification System (POP-Q) scale at baseline and after 12 months. The Pelvic Floor Disability Index-20 (PFDI-20), along with its symptom scales, were evaluated. The mean age 42 operated women was 64.5 years, and the average BMI was 27.3 (83% women were overweight). At baseline, 29 (69%) women had POP stage IV, and 13 (31%) women had POP stage III. Overall, 14 (33%) underwent laparoscopy, 28 (67%) underwent laparotomy. At 12 months, 14 (33.3%) women had POP stage I; 21 (50%) women had POP stage II. Seven patients (16.6%) experienced a recurrence of disease with advancement at the degree of III/IV; 4 (9.5%) women required adjuvant surgery in the form of anterior and posterior vaginal wall surgery. No early complications after surgery were observed. The comparison of the results before and after surgery showed statistically significant improvement in terms of the P-QoL score as well as PFDI-20 along with its 3 symptom scales. Anterior abdominal fixation of the uterus to the anterior abdominal wall is effective, safe, and technically easy to perform in the treatment of POP of advanced stage.