Postoperative pelvic dysfunctions associated with the reconstruction of the pelvic floor.

Abstract

The authors were aiming to conduct the comparative analysis of the frequency of formation of pelvic dysfunctions after surgical correction of genitalia prolapse in women by a vaginal approach using native tissue repair of the vaginal paries and synthetic implants. The study included 546 patients with stage II-IV genitalia prolapse according to the POP-Q classification. The quality of life was assessed using PD-QL and PFIQ-7 questionnaires. The 1st group included patients after native tissue repair (N.=314), the 2nd - after surgery with the use of synthetic implants (N.=232). In the 1st group de-novo dysfunctions were revealed as follows: stress urinary incontinence: in 4.9% of women, urgency: in 2.2%, obstructive urination: in 8.0%; constipation or fecal and flatal incontinence: none. The index of pelvic floor dysfunction decreased from 50±14% to 8±2%. The index of influence on the quality of life decreased from 81±14% to 9% after 12 months. In the 2nd group, de-novo dysfunctions were revealed as follows: stress urinary incontinence: in 9.5% of women, urgency: in 9.1%, obstructive urination: in 23.7%; constipation or fecal and flatal incontinence: 1 patient (0.4%). In patients of the 2nd group, there was a decrease in the pelvic floor dysfunction index from 48±12% to 10±2%. The index of influence on the quality of life decreased from 79±15% to 5% after 12 months. The use of synthetic implants causes the formation of de novo pelvic dysfunctions more often than the native tissue repair.