Abstract
The aim of this study was to assess the effectiveness of vaginal native tissue repair (VNTR) on preexisting Lower Urinary Tract Symptoms (LUTS) in women with symptomatic pelvic organ prolapse (POP). Two hundred patients who underwent VNTR for symptomatic POP from January 2018 to February 2019 were followed up for 6 months. All patients underwent VNTR, but in the posterior compartment, the rectovaginal fascia was reconnected to the uterosacral ligaments and additionally sutured to the iliococcygeus fascia and muscle. To assess the severity and change in storage phase LUTS before and after surgery, all participants were asked to complete 3 questionnaires: the International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), Urogenital Distress Inventory-6 (UDI-6), and Incontinence Impact Questionnaire-7 (IIQ-7). The data were assessed with Statistica package version 12.0, using Kalmogorow–Smirnoff, W Shapiro–Wilk tests. Furthermore, one-way analysis of variance was applied with post-hoc Tukey test. The study results indicate that the majority of patients with advanced POP suffered from various LUTS. Among storage symptoms, the occurrence of urinary incontinence (UI) and urgency decreased significantly after surgery. Moreover, ICIQ-SF, UDI-6, and IIQ-7 results showed statistically significant improvement in the impact of UI on the quality of life (QoL) in the vast majority of patients after surgery. VNTR is an effective way to treat not only anatomical, but also functional problems in such patients.
Highlights
Pelvic organ prolapse (POP) and accompanying functional disorders are significant epidemiological, medical, and social problems
It was found that patients with advanced prolapse who underwent reconstructive surgery are at risk of developing undesired postoperative lower urinary tract symptoms (LUTS) if they are over the age of 66, are burdened with additional neurological factors and postvoid residual (PVR) ≥ 200 mL [4]
Keeping the above in mind, the primary aim of the present study was to assess the influence of vaginal native tissue repair (VNTR) on the preexisting common LUTS in patients with symptomatic pelvic organ prolapse (POP-Q II-IV)
Summary
Pelvic organ prolapse (POP) and accompanying functional disorders are significant epidemiological, medical, and social problems. POP is a common phenomenon often requiring surgical correction due to the bothersome symptoms reported by patients [2,3]. It was found that patients with advanced prolapse who underwent reconstructive surgery are at risk of developing undesired postoperative LUTS if they are over the age of 66, are burdened with additional neurological factors and postvoid residual (PVR) ≥ 200 mL [4]. The etiology of the prolapse is multifactorial It is generally associated with the pressure exerted by internal organs (urinary bladder, uterus, intestines) on the pelvic floor, whose biomechanical strength is impaired due to congenital genetic defects, previous surgical procedures, or neurodegenerative changes resulting from perinatal damage or neurological disorders [5]. In the case of advanced prolapse, the only really effective way of treatment is reconstructive pelvic surgery. The majority of women accept short-term use of pessaries for the temporary treatment of symptomatic POPs, this method is not accepted in long-term use due to lack of permanent effectiveness [6]
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