Abstract
Background: Regardless of a variety of surgical techniques and hi-tech materials for pelvic prolapse treatment, there is no decrease in the disease recurrences.
 Aims: Evaluation of the efficacy of the developed method of surgical correction of IIIV degree colpoptosis anterior combined with IIIII degree C-prolapse with the use of titanium mesh implants in reproductive, pre- and postmenopausal female patients.
 Methods: Female patients (group I, n = 25) with colpoptosis anterior and cervical prolapse were examined and operated on according to the developed know-how technique with the use of titanium mesh implants. Evaluation of the efficacy of surgical correction of the disease was performed using questioning, pelvic exam with Valsalva manoeuvre, transvaginal and transperineal ultrasound, pelvis MRI. The findings were compared with the result of surgical treatment of 46 (group II) and 32 (group III) female patients operated on without the use of titanium implants. After surgical treatment according to the three-stage surgical program that provides for multifocal fixation of anatomical formations with the use of titanium implants, the case follow-up was performed in 321 months.
 Results: Questioning the patients in group I demonstrated their satisfaction with the surgical treatment results that positively affected the quality of life, mood, and contributed to an increase in sexual activity and community commitment. Check-up showed that the surgical correction of prolapse was completely preserved in the patients of group I during 1821 months. Pelvic exam at rest and with Valsalva manoeuvre, transvaginal and transperineal ultrasound, pelvis MRI did not reveal any significant extrusion of the pelvic organs or titanium implants. No mesh-associated complications were observed during the follow-up. Recurrence of genital prolapse was diagnosed in 12 (26%) patients of group II, mesh-associated complications were detected in 6 (18.8%) women of group III.
 Conclusions: The preserving three-stage surgical program, developed by us, contributed to optimize the results of surgical treatment, decrease the rate of the disease recurrence, and reduce the risk of the development of mesh-associated complications.
Highlights
Regardless of a variety of surgical techniques and hi-tech materials for pelvic prolapse treatment, there is no decrease in the disease recurrences
Evaluation of the efficacy of the developed method of surgical correction of II–IV degree colpoptosis anterior combined with II–III degree “C”-prolapse with the use of titanium mesh implants in reproductive, pre- and postmenopausal female patients
The findings were compared with the result of surgical treatment of 46 and 32 female patients operated on without the use of titanium implants
Summary
Вестник РАМН. — 2020. — Т.75. — No1. — С. 18–26. Annals of the Russian Academy of Medical Sciences. 2020;75(1):. Цель исследования ― оценка эффективности разработанного способа хирургической коррекции опущения передней стенки влагалища II−IV степени в сочетании с С-пролапсом II−III степени при помощи титановых сетчатых имплантатов у пациенток репродуктивного, пре- и постменопаузального возраста. (Для цитирования: Ищенко А.И., Александров Л.С., Ищенко А.А., Казанцев А.А., Хохлова И.Д., Джибладзе Т.А., Горбенко О.Ю., Чушков Ю.В., Зуев В.М., Маневская Ю.Б., Ушкова А.Д. Согласно данным многоцентрового исследования [8], Критерии включения в исследование для II и III (консовокупное количество mesh-ассоциированных и обще- трольных) групп: хирургических осложнений при коррекции генитального опущение передней стенки влагалища II−IV степени пролапса составляет 22,4%. Цель исследования ― оценка эффективности разрау пациенток репродуктивного, пре- и постменопауботанного способа хирургической коррекции опущения зального возраста; передней стенки влагалища II−IV степени в сочетании согласие на хирургическое вмешательство в объеме с С-пролапсом II−III степени при помощи титановых передней кольпорафии (46 чел.) и переднего Prolift сетчатых имплантатов у пациенток репродуктивного,. Sechenov First Moscow State Medical University (Sechenov University), Мoscow, Russian Federation 2 Central Clinical Hospital of the Russian Academy of Sciences, Moscow, Russian Federation 3 Treatment and rehabilitation center, Moscow, Russian Federation
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