Petruzzelli Paolo, Chiadò Fiorio Tin Michela, Cosma Stefano, Parisi Silvia, Garofalo Anna, Todros Tullia
Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy.
Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science, University of Torino, Torino, Italy.
Int J Gynaecol Obstet. 2016 Oct;135(1):101-6. doi: 10.1016/j.ijgo.2016.03.028. Epub 2016 Jun 16.
To evaluate the safety, efficacy, and feasibility of a minimally invasive vaginal approach for treating advanced utero-vaginal prolapse.
A prospective study enrolled consecutive patients attending the Gynecology and Obstetrics Department, Turin University for treatment of Pelvic Organ Prolapse Quantification (POP-Q) stage III of higher symptomatic utero-vaginal prolapse between February 1, 2013 and November 30, 2014. Participants underwent a combined sacrospinous hysteropexy and cystopexy procedure using a single anterior vaginal incision. Surgical procedures were performed by one of two surgeons, either an experienced senior surgeon or a resident surgeon under supervision. POP-Q staging, patient symptoms, and quality of life were evaluated before and after surgery.
The present study enrolled 42 patients and 19 (45%) were discharged on the first post-operative day. The mean operating time was 40.5±10.6minutes and there was no significant difference in operating time between the two surgeons. With an average follow-up duration of 13months, significant post-surgical improvements were recorded across both POP-Q anterior (P<0.001) and apical (P<0.001) domains, and in both prolapse impact (P<0.001) and urinary impact (P=0.001) quality-of-life measures; one apical recurrence and no major complications were recorded.
Combined sacrospinous hysteropexy and cystopexy through a single incision appears to be a safe and efficacious procedure that was relatively easy for surgeons to learn and resulted in a fast post-surgical recovery.
