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.
There were executed experimental studies on test subjects of microbial (Staphylococcus aureus and Pseudomonas aeruginosa) and neoplastic nature (in vitro - suspension of cells of the line of chronic myelogenous leukemia K562 in a volume of 60 μl and in an amount of 60 ± 1 × 103, in vivo - mice infected with Ehrlich carcinoma) on the substantiation the use of chlorophyll-containing drugs activated for photodynamic therapy (PDT) outside the biological object. No additional PDT activation of the drug was performed.The high bactericidal (on the test objects of microbes) and anti-tumor PDT efficacy of chlorophyll-containing preparations activated outside the organism was substantiated, with their subsequent administration per os and accumulation in practically all organs and tissues of the body was validated. The developed medical diagnostic technology in its clinical application has proved its effectiveness in women with inflammatory and/or neoplastic processes of the pelvic organs. The used equipment and preparation are approved for clinical use.
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