MINIMALLY INVASIVE TREATMENT OF UROGENITAL PROLAPSE USING AMI I-STITCH

Abstract

Introduction. Genital prolapse is a pelvic static disorder, which represents the descending of the vaginal walls and the uterus in the vaginal axis with their exteriorization through vaginal introit. It is a public health problem, with a risk of occurrence of 30-40% in women over 40 years old, of 20-30% in multiparous, of about 20% after surgeries, having as the main cause injuries to pelvic supporting and suspension structures. The objective of this paper is to compare the classic transvaginal surgical technique of mounting the prosthesis to the bilateral sacrospinous ligament with the technique of fixing the mesh to the sacrospinous ligament using the I-Stitch device. Materials and methods. Between 2010 and 2017, in the Sibiu Urology Clinic, there were diagnosed 57 patients (p) with urogenital prolapse who benefited from colpopexy by fixing the polypropylene mesh to the sacrospinous ligament using the I-Stitch device and colpopexy by classically fixing the mesh. Results. In the group using the I-Stich device, mean operative time was 48.5 minutes (between 35 and 110 minutes), mean blood loss was 140 ml (90-300 ml), postoperative pain present in 5 p (8.77%), hospitalization length between 2 and 5 days with an average of 3.2 days. Conclusion. Reconstructive surgery of pelvic floor is a combination of surgical procedures designed to correct multiple defects, is definitive and curative in the treatment of prolapse.