Estudo randômico da correção cirúrgica do prolapso uterino através de tela sintética de polipropileno tipo I comparando histerectomia versus preservação uterina

Carramão, Sílvia da Silva; Auge, Antônio Pedro Flores; Pacetta, Aparecida Maria; Duarte, Eliana; Ayrosa, Paulo; Lemos, Nucelio; Aoki, Tsutomu

doi:10.1590/s0100-69912009000100012

Cited by 21 publications

(13 citation statements)

References 20 publications

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“…In some studies, it was showed that after hysterectomy and pelvic reconstruction with a mesh, mesh erosion rates are as high as 20% (12). In our study, we did not perform a hysterectomy and any peritoneal incisions, and we did not observe any mesh erosions.…”

Section: Discussioncontrasting

confidence: 40%

Evaluation of the Results of Patients Who Were Treated with Laparoscopic Simple Tunnel Hysterosacropexy Method to Prevent Uterine Prolapse: A New Approach

Şeker

Elçi

2021

Gynecol Obstet Reprod Med

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OBJECTIVES: To evaluate the results of patients with uterine prolapse who underwent laparoscopic simple tunnel hysterosacropexy as uterine protective surgery. In this surgical procedure, the parietal peritoneum which was cut off in traditional surgery is preserved. STUDY DESIGN: Data from women with apical prolapse of stage 2 or higher who underwent laparoscopic simple tunnel hysterosacropexy between October 1, 2017, and March 31, 2019, at the University of Health Sciences Diyarbakır Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey was retrospectively assessed. Patients were treated with laparoscopic simple tunnel hysterosacropexy; the meshes were anchored to the posterior cervical area, even in the presence of advanced multi-compartment vaginal prolapse. Data on the prolapse stage and urogenital functions were collected through clinical examinations, questionnaires at baseline, and 6 months after the operation. Results were analyzed using Wilcoxon Signed Ranks Test and Based on positive ranks. Data are presented as mean, minimum, maximum or percentage according to variables. RESULT: Overall, 12 women were included in the analysis; the mean follow-up was 6 months. There were significant improvements in the complaints and POP-Q values of patients included in the study. There were not any complications during the intraoperative period and postoperative follow-ups. During the first six-month follow-up, there were not any recurrence of prolapse. The mean operative time was 146 minutes; there were no intraoperative visceral or vascular injuries. There was no recurrence or vaginal erosion. CONCLUSION: In patients with stage 2 and more severe uterine prolapse, laparoscopic simple tunnel hysterosacropexy can be performed without cutting the peritoneum. Since the peritoneum is not cut during the surgery; intestinal injury prevalence and mesh exposure rates are lower.

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Section: Discussioncontrasting

confidence: 40%

Evaluation of the Results of Patients Who Were Treated with Laparoscopic Simple Tunnel Hysterosacropexy Method to Prevent Uterine Prolapse: A New Approach

Şeker

Elçi

2021

Gynecol Obstet Reprod Med

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“…Korbly goes further to show that 36% of women preferred uterus preservation even if it has less surgical efficacy 20 . Uterus preservation at the time of TVM placement is plausible as demonstrated by various studies with equal or non-inferior surgical outcomes compared to those in concomitant hysterectomy 10 – 12 . Cure rates range from 75% to 98%, with the advantages of longer vaginal length, shorter operation time, less blood loss and less post-operation pain, which are all in agreement with this current study.…”

Section: Discussionmentioning

confidence: 95%

“…Previous studies on concomitant hysterectomy during TVM insertion used earlier mesh products, namely Nasca 10 , Perigee, Apogee 11 , Elevated system 12 and Prolift 7 . These reports varied in sample sizes (31–142 patients), mesh used and followed up periods (8.9–54 months), but they shared similar findings.…”

Section: Introductionmentioning

confidence: 99%

“…Primary outcome with POP-Q found all parameters comparable between hysteropexy and hysterectomy groups, except for longer total vaginal length in the hysteropexy patients. Secondarily, hysteropexy groups experienced less operation time, less blood loss, shorter hospital stay and less mesh extrusion rates 7 , 10 – 12 . Similar findings were reported by Forde in his study with 1,601 women and follow-up period up to 3 years 13 .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of UpholdTM Vaginal Mesh Procedure with Hysterectomy or Uterine Preservation for the Treatment of Pelvic Organ Prolapse

Ker

Lin

Loo

et al. 2018

Sci Rep

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Hysterectomy is the empirical treatment for female pelvic organ prolapse (POP) without robust evidence to prove its efficacy. Uphold transvaginal mesh (TVM) system is an innovated device with smaller area, superior anterior/apical support with single incision to treat POP. The prospective cohort study aims to evaluate Uphold TVM’s performance with or without concomitant hysterectomy. Inclusion criteria specify patients suffering from stage 2 or more anterior/apical prolapse without previous hysterectomy. Exclusion criteria specify those with contraindications to uterine preservation, such as leiomyomas, adenomyosis, endometrial hyperplasia, abnormal uterine bleeding, postmenopausal bleeding, cervical dysplasia, receiving tamoxifen treatment, family history of gynecology cancer, or colon cancer and incapability to be routinely followed. Thirty patients are recruited in the hysterectomy group and 66 patients in the hysteropexy group. The results demonstrate that patients with Uphold mesh only experience longer vaginal length, shorter operation duration, less blood loss and less post-operation pain. The performance in anatomical correction, lower urinary tract symptoms improvement, de novo dyspareunia, urodynamic study parameters and mesh extrusion rates are comparable with or without uterus preservation. The information is useful in pre-operation counseling, when the patient can make an educated choice whether or not to receive concomitant hysterectomy.

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“…Due to the deterioration of blood supply in the upper third of the vagina caused by a hysterectomy, the rate of mesh erosions is high and in some cases makes a subsequent sacrocolpopexy necessary. Some authors found mesh erosion rates as high as 20% after a hysterectomy and a pelvic reconstruction with a mesh [ 3 ]. The overall rate of mesh erosion after sacrocolpopexy in Nygaard et al was 3.4% (in 70 out of 2178 cases) [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic hysterosacropexy in case of total uterus prolapse – case report

Szymanowski

Szepieniec

Gruszecki

et al. 2018

International Journal of Surgery Case Reports

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Estudo randômico da correção cirúrgica do prolapso uterino através de tela sintética de polipropileno tipo I comparando histerectomia versus preservação uterina

Cited by 21 publications

References 20 publications

Evaluation of the Results of Patients Who Were Treated with Laparoscopic Simple Tunnel Hysterosacropexy Method to Prevent Uterine Prolapse: A New Approach

Evaluation of the Results of Patients Who Were Treated with Laparoscopic Simple Tunnel Hysterosacropexy Method to Prevent Uterine Prolapse: A New Approach

Comparison of UpholdTM Vaginal Mesh Procedure with Hysterectomy or Uterine Preservation for the Treatment of Pelvic Organ Prolapse

Laparoscopic hysterosacropexy in case of total uterus prolapse – case report

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