Apical Prolapse: Is There a Best Approach?

Heft, Jessica; Adam, Rony A.

doi:10.1007/s11884-018-0469-0

Cited by 4 publications

(4 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was one case of left ventricular failure who was managed conservatively in Group 1. Other early complications including vault infection (5), urinary tract infection (UTI) (21), urinary urgency (2), gastritis (2), spinal headache (4), right bundle branch block (1), respiratory infection (2), urinary incontinence (2), febrile morbidity (1), urinary retention (1), hypoglycaemia (1) occurred in both groups without any statistically significant difference. No patient required post-operative surgical intervention.…”

Section: Resultsmentioning

confidence: 99%

“…Pax et al found anterior compartment recurrence rate of more than 50% and posterior compartment defects of more than 15% at 3 years when VH-PFR-M was done in patients with advanced prolapse [4]. The literature suggests high recurrence in patients with both VH-PFR-M and VH-PFR procedures [5,6]. Alas et al [7] found that there was a significant increase in anterior compartment defects at 1 year in patients with advanced prolapse who underwent VH-PFR-M.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have conflicting views on the role of SSF with regard to operating time, blood loss, complications and prolapse recurrence [1,5,10,11]. Elif et al found statistically significant increase in operating time, hospital stay and blood loss requiring blood transfusion in the SSF group [6].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Is performing sacrospinous fixation with vaginal hysterectomy and McCall’s culdoplasty for advanced uterovaginal prolapse preferable over McCall’s culdoplasty alone?

Rajan

Varghese

Roy

et al. 2019

J Obstet Gynecol India

View full text Add to dashboard Cite

Purpose of study Advanced uterovaginal prolapse can significantly affect the quality of life in women and usually requires surgical management. McCall's culdoplasty (M) or sacrospinous fixation (SSF) are done at the time of vaginal hysterectomy with pelvic floor repair (VHPFR) to reduce recurrence, but recurrence rates of 15% and 33% have been reported with these procedures respectively. We hypothesize that combining VH-PFR with both McCall's culdoplasty and sacrospinous fixation (VH-PFR-M-SSF) may decrease recurrence rates compared to VH-PFR-M without significantly affecting other perioperative outcomes. Methods All patients with advanced uterovaginal prolapse and willing for VH-PFR at our institute from January 2015 to March 2018 were included after informed consent, except for medically unfit women and those preferring alternative management. We conducted a case control study comparing VH-PFR-M and VH-PFR-M-SSF with a follow-up period of 24 months. Qualitative and quantitative data were statistically analysed and Odds ratio and 95% Confidence interval was calculated. Kaplan Meier Curve was drawn and Log Rank test was used to compare recurrence. Results Out of 174 patients who underwent surgery in the study period, 131 patients (75.28%) underwent VH-PFR-M and 43 patients (24.71%) underwent VH-PFR-M-SSF. Both groups were comparable for age, body mass index, parity, postmenopausal status, comorbidities and aggravating factors. Patients with higher stage of prolapse were more in group 2 (p < 0.001). There were no intraoperative complications or postoperative surgical interventions in either group. The duration of surgery was not significantly different. Change in haematocrit was more in group 2 but no patient required blood transfusion. There was no statistically significant difference in recurrence rates between the 2 groups. Conclusion The procedure (VH PFR M-SSF) is safe and affordable with good results in Stage 3 with advanced bulge and stage 4 prolapse.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is performing sacrospinous fixation with vaginal hysterectomy and McCall’s culdoplasty for advanced uterovaginal prolapse preferable over McCall’s culdoplasty alone?

Rajan

Varghese

Roy

et al. 2019

J Obstet Gynecol India

View full text Add to dashboard Cite

show abstract

“…Previous studies comparing SSF and MCC procedures have conflicting views on the role of SSF with regard to operating time, blood loss, complications and prolapse recurrence. [16][17][18] Elif et al found statistically significant increase in operating time, hospital stay and blood loss requiring blood transfusion in the SSF group. 19 Colombo et al found SSF inferior to McCall's culdoplasty in terms of operative time, blood loss and recurrence.…”

Section: Discussionmentioning

confidence: 98%

The effect of reconstructive vaginal surgery on quality of life and sexual functions in postmenopausal women with advanced pelvic organ prolapse in intermediate-term follow-up

Karaca

2021

Post Reprod Health

View full text Add to dashboard Cite

Objective To compare sexual function and quality of life in women who underwent McCall culdoplasty versus sacrospinous ligament fixation for pelvic organ prolapse. Materials and methods This study was conducted in our urogyanecology clinic between July 2015 and June 2019. We included sexually active postmenopausal women who had undergone either McCall culdoplasty ( n:80 patients) or sacrospinous ligament fixation ( n:38 patients) procedure for threatened POP. Patients in both groups were matched according to age and body mass index. Sexual function between both groups was evaluated with the pelvic organ prolapse/urinary incontinence sexual function 12 patient-reported outcome measures (PROMs) and quality of life with the prolapse quality of life (PQOL) PROMs. Results Emotional domain was low in the McCall culdoplasty group (21.4 ± 10.1 vs. 30.8 ± 15.2; p = 0.03). There were no significant differences in other P-QOL domains. Pain during intercourse was more in the sacrospinous ligament fixation group (2.9 ± 1.6 vs. 1.3 ± 1.1; p = 0.04). The mean operation time in the McCall culdoplasty group was shorter than the sacrospinous ligament fixation group ( p = 0.03). There was no difference between the two surgical procedures performed in terms of intraoperative blood loss and hospital stay. The prevalence of recurrence in the McCall culdoplasty group was 6.2%, and that of sacrospinous ligament fixation was 5% ( p = 0.75) in one year follow-up. Conclusion Our study demonstrated that McCall culdoplasty has a more positive effect on QOL and sexuality than sacrospinous ligament fixation in appropriately selected patients. McCall culdoplasty could be considered as a good option in the treatment of advanced pelvic organ prolapse in elderly patients.

show abstract

Comparación entre el uso de malla de prolene y cinta de mersilene en la sacrohisteropexia abdominal para el prolapso apical: ensayo clínico aleatorizado

Anter

Ellakwa

Sanad

et al. 2023

Actas Urológicas Españolas

View full text Add to dashboard Cite

Apical Prolapse: Is There a Best Approach?

Cited by 4 publications

References 81 publications

Is performing sacrospinous fixation with vaginal hysterectomy and McCall’s culdoplasty for advanced uterovaginal prolapse preferable over McCall’s culdoplasty alone?

Is performing sacrospinous fixation with vaginal hysterectomy and McCall’s culdoplasty for advanced uterovaginal prolapse preferable over McCall’s culdoplasty alone?

The effect of reconstructive vaginal surgery on quality of life and sexual functions in postmenopausal women with advanced pelvic organ prolapse in intermediate-term follow-up

Comparación entre el uso de malla de prolene y cinta de mersilene en la sacrohisteropexia abdominal para el prolapso apical: ensayo clínico aleatorizado

Contact Info

Product

Resources

About