Jimma University Institute of Health, Department of Obstetrics and Gynecology, Jimma University, Jimma, Ethiopia.
Urogynecology and Reconstructive Pelvic Surgeon, Saint Joseph-Saint Luc Hospital, Lyon, France.
BMC Womens Health. 2022 Oct 7;22(1):410. doi: 10.1186/s12905-022-01992-8.
Pelvic organ prolapse (POP) affects about half of the women and affects their quality of life. The current study is, therefore, aimed at determining the prevalence and surgical outcomes of severe stage POP at Jimma University medical center from November 2016 to May 2018.
A Hospital-based cross-sectional study was conducted on all patients with stage 3 and 4 POP, who were admitted, and had surgery. Data were collected from the patient's chart, and logbooks, which were filled up from entry till her discharge. A Simplified POPQ(S-POPQ) was used to stage the prolapse at admission, at discharge, and three months follow-ups.
Among 92 patients who were analyzed, POP accounts for 10.6% of all gynecologic admissions, and 43.8% of all gynecologic surgeries. The mean age of patients is 46 (± 12) years, and nearly 34% of the patients had stage 3 and 66% had stage 4 POP. Based on the type of prolapse, 93.5% of patients had stage 3 and more anterior vaginal wall prolapse (AVWP) and apical prolapse, while 57.6% had stage 3 or more posterior vaginal wall prolapse. Out of 72 patients who had anterior colporrhaphy, 58.7% had anterior colporrhaphy with colposuspension. Out of 83 patients who had apical suspension, 48.2%, 39.8%, and 12% had uterosacral, sacrospinous, and Richardson respectively. Ninety-seven patients had stage 0 or 1 POP at discharge while 90% of 20 patients who returned for follow-up at three months had stage 0 or 1 POP. Eight patients had surgery-related complications; bladder injury, urinary retention, Hemorrhage during SSLF, and rectal injury.
The prevalence of pelvic organ prolapse is high and the majority of patients presented with advanced-stage pelvic organ prolapse, with a long duration of symptoms and associated problems. The surgical techniques used have resulted in a high immediate success rate of 97% and 90% at discharge and three months follow up respectively. Therefore, awareness creation activities are important to facilitate an early presentation for treatment to improve the quality of life and the current surgical technique; native tissue vaginal repair (NTVR), being practiced in the setup has had better success.
盆腔器官脱垂（POP）影响约半数女性，并影响其生活质量。因此，本研究旨在确定 2016 年 11 月至 2018 年 5 月期间在 Jimma 大学医学中心接受手术治疗的严重程度 3 期和 4 期 POP 患者的患病率和手术结果。
对所有 3 期和 4 期 POP 患者进行基于医院的横断面研究，这些患者入院并接受了手术治疗。数据来自患者病历和日志，从入院到出院期间填写。在入院、出院和三个月随访时使用简化盆腔器官脱垂量化（S-POPQ）对脱垂进行分期。
在 92 例接受分析的患者中，POP 占妇科住院患者的 10.6%，占妇科手术的 43.8%。患者的平均年龄为 46（±12）岁，近 34%的患者患有 3 期 POP，66%的患者患有 4 期 POP。根据脱垂类型，93.5%的患者患有 3 期及以上前阴道壁脱垂（AVWP）和顶端脱垂，而 57.6%的患者患有 3 期或以上后阴道壁脱垂。在 72 例行前阴道壁修补术的患者中，58.7%行前阴道壁修补术加阴道中段悬吊术。在 83 例行顶端悬吊术的患者中，分别有 48.2%、39.8%和 12%行骶骨阴道固定术、骶棘韧带固定术和 Richardson 修补术。97 例患者出院时 POP 分期为 0 期或 1 期，而 20 例在三个月时返回随访的患者中有 90%的 POP 分期为 0 期或 1 期。8 例患者发生手术相关并发症：膀胱损伤、尿潴留、骶骨阴道固定术期间出血和直肠损伤。
盆腔器官脱垂的患病率较高，大多数患者表现为晚期盆腔器官脱垂，且症状持续时间长，并伴有相关问题。所采用的手术技术在出院时即刻成功率高达 97%，在三个月随访时成功率高达 90%。因此，开展提高认识的活动非常重要，以促使患者尽早就诊治疗，提高生活质量。目前在该机构实施的自然组织阴道修复术（NTVR）取得了更好的效果。
