The results of five years follow-up prospective study of vaginal prolapse repaired by prolift total mesh surgery or sacrospinous fixation

Česká verzia

Authors: P. Kraus ¹; L. Krofta ^2,3; M. Krčmář ^2,3; I. Urbánková ²; O. Gojiš ²; K. Grogregin ²; J. Feyereisl ^2,3,4
Authors place of work: Gynekologicko-porodnická klinika FZS UJEP a MN, Ústí nad Labem, přednosta doc. MUDr. T. Binder, CSc. ¹; Ústav pro péči o matku a dítě, Praha, ředitel doc. MUDr. J. Feyereisl, CSc. ²; 3. lékařská fakulta Univerzity Karlovy, Praha, děkan prof. MUDr. M. Anděl, CSc. ³; Katedra gynekologie a porodnictví IPVZ, Praha, vedoucí MUDr. A. Malina, Ph. D., MBA ⁴
Published in the journal: Ceska Gynekol 2017; 82(4): 277-286

Summary

Objective:
The aim of the study is to compare the results of five years follow-up prospective study of vaginal prolapse repaired by prolift total mesh surgery or sacrospinous fixation.

Study design:
A single-center prospective, cohort study, in patients with defect grade II and more by POP-Q.

Setting:
The Institute for the Care of Mather and Child; 3rd Medical Faculty Charles university, Prague.

Methods:
Comparison of the preoperative state and the five years after the operation according POP Q, ICIQ-SF, PISQ 12, VAS. Comparison of intraoperative and postoperative complications.

Results:
The study was attended by 142 patients; 75 patients underwent surgery Prolift Total and 67 patients sacrospinous fixation by Amreich Richter. On clinical examination at 5-year follow-up, we observed 15 (20.0%) case of anatomical failure in the Prolift group and 30 (44.8%) in the SSF group. Anatomic failure was defined clinically as Ba, C or Bp at the hymen or below. In assessing the overall condition before and five years after surgery using a VAS occurred in patients in the cohort Prolift Total decrease to 2.9 (± 1.9) from the original 7.8 (± 1.8). VAS in SSF group decreased after 5 years to 4.2 (± 2.7) of the original 7.8 (± 1.4). Values ICIQ-SF, analyzing the state of voiding PT group showed a decline from the original 6.7 (± 6.9) to 5.5 (± 5.3). A similar trend was evident even after the SSF. Parameters questionnaire PISQ-12 showed a positive increase from the original 28.6 (± 9.5) to 31.8 (± 7.9) points. PISQ-12 was improved from 28.7 (± 9.8) to 32.2 (± 7.5).

Conclusion:
Recurrences were observed more frequently in patients after sacrospinous fixation, while the quality of life questionnaires yielded comparable postoperative results. Quantity of intraoperative complications is low and both groups do not differ.

Keywords:
prolapse, Prolift Total, mesh implant, sacrospinous fixation, Amreich Richter

Zdroje

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