Surgical Treatment of Pelvic Static Disorders - General Principles and Discussions

Abstract

Introduction: Pelvic static disorders have a major impact on patients’ quality of life, constituting a real public health problem, despite the fact that they are not life-threatening. Pelvic static disorders are characterized by varying degrees of damage to the structures of the pelvic floor, which leads to the appearance of some anatomical-clinical entities, the most common of which are urinary incontinence and pelvic organ prolapse. There is no consensus regarding the optimal treatment of pelvic static disorders, reconstruction techniques being extremely numerous, from classic techniques, which use the patients’ own tissues to laparoscopic techniques and those using alloplastic materials Methods: In the Surgery Clinic I of SCJU Constanța, 89 surgical interventions for the correction of uterine prolapse and 22 interventions for the correction of vaginal vault prolapse were performed on a group of 327 patients, using both reconstructive and obliterative surgical techniques Results: The best anatomical success rate was achieved by performing laparoscopic colposuspension by the lateral suspension procedure, followed by laparoscopic sacrocolpopexy and colposuspension at the sacrospinous ligaments Conclusions: Hystero/colposuspension is a lateral fixation procedure that fulfills the four major goals of surgical prolapse cure: reduction of prolapse, absence of functional symptoms, patient satisfaction, and avoidance of complications. The technique is simple, requires a short operative time with minimal operative trauma, rapid postoperative recovery with a high degree of satisfaction in terms of quality of life and early socio-professional integration of the patients.