V13-09 THE THREE-LEVEL UTERUS-SPARING REPAIR OF ADVANCED PELVIC ORGAN PROLAPSE WITH THE USE OF ULTRAMINIMESH

Abstract

You have accessJournal of UrologyFemale Pelvic Surgery (V13)1 Apr 2020V13-09 THE THREE-LEVEL UTERUS-SPARING REPAIR OF ADVANCED PELVIC ORGAN PROLAPSE WITH THE USE OF ULTRAMINIMESH Dmitry Shkarupa*, Nikita Kubin, Olga Staroseltseva, Ekaterina Shapovalova, Anastasia Zaytseva, and Alexander Petrov Dmitry Shkarupa*Dmitry Shkarupa* More articles by this author , Nikita KubinNikita Kubin More articles by this author , Olga StaroseltsevaOlga Staroseltseva More articles by this author , Ekaterina ShapovalovaEkaterina Shapovalova More articles by this author , Anastasia ZaytsevaAnastasia Zaytseva More articles by this author , and Alexander PetrovAlexander Petrov More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000970.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: According to J.O. DeLancey, the structures that support the pelvic floor are divided into three levels. The majority of existing treatment methods of pelvic organ prolapse (POP) is aimed at 1 and 2 levels. At the same time according to the modern data the structures of the 3 level allow to break the excessive tension from the ligaments/fascias and is a kind of the basis of the above located levels of support. Besides, the minimizing of synthetic materials use in vaginal surgery is very actual issue. The purpose of this study was to evaluate the efficiency and safety of the three-level uterus-sparing repair of advanced POP using ultraminimesh. METHODS: This prospective study involved 209 women suffering from POP (stage III-IV, POP-Q), who underwent transvaginal reconstruction of all levels of support (according to J.O. DeLancey): unilateral sacrospinal fixation using apical sling (level 1), anterior and posterior subfascial colporrhaphy (level 2) and perineorrhaphy (level3) (fig. 1). The patients were examined 12 months after the surgery, including vaginal examination, assessment of POP according to the POP-Q system and completion of validated questionnaires (PFDI-20, PISQ-12, VAS). RESULTS: Mean operation time was 58.2 ± 9.7 minutes. No intraoperative bladder injuries or clinically significant bleeding were observed. Postoperative data were obtained in 185 (88.2%) patients. The anatomical success rate (stage ≤ I, POP-Q) of follow-up was 95.1%. Anatomical recurrence at the apical level (C> -1) was detected in 1 (0.5%) patient, and in the anterior compartment (Ba≥-1) in 8 (4.3%) patients. During the observation period only one case of suture material extrusion was recorded. None of the patients complained of pain in the area of surgery. However, one woman noted de novo dyspareunia. SUI de novo developed in 6 (3.2%) patients. Most of the patients reported a significant improvement in the quality of life after treatment. Satisfaction with the treatment outcome according to questionnaires was 94.7%. CONCLUSIONS: The reconstruction of the all levels of support of the pelvic floor allows to distribute the load between compartments and therefore, to reduce the amount of used synthetic material while maintaining high efficiency and safety of the surgery. Source of Funding: None. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1213-e1213 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dmitry Shkarupa* More articles by this author Nikita Kubin More articles by this author Olga Staroseltseva More articles by this author Ekaterina Shapovalova More articles by this author Anastasia Zaytseva More articles by this author Alexander Petrov More articles by this author Expand All Advertisement PDF downloadLoading ...