ABSTRACT
Background: Stress incontinence is one of the most common but debilitating health issue among women. It has a detrimental effect on overall health and quality of life of women. Trans obturator tape (TOT) has emerged as a promising treatment modality. The aim of present study was to assess the usefulness of TOT in terms of change in quality of life of stress incontinence patients.Methods: The study was performed at Department of Obstetrics and Gynecology, Acharya Shri Chandler of Medical Sciences (ASCOMS), Jammu. A total of 50 symptomatic women were enrolled in the study and underwent TOT procedure using outside-in technique. The quality of life of women was assessed at enrolment and 12 months after the procedure using King’s Health Questionnaire (KHQ). Change in QOL was assessed using paired ‘t’-test.Results: After 12 months follow-up, a total of 27 (54%) patients were entirely symptom free. As compared to pre-treatment QOL assessment on KHQ for general health/incontinence impact, quality of life and symptom scores a % decline of 73.2%, 79.8% and 78.4% was observed. For all the three parts, the change in scores was significant statistically. No other complications and side effects were reported.Conclusions: TOT is a useful procedure which provided symptomatic relief as well as QOL enhancement.
ABSTRACT
Background: Pelvic organ prolapse is common in women and 7-9% undergo surgical repair. Abdominal sacrocolpopexy and sacrohysteropexy is the most durable operation for vault prolapse and Nulliparous prolapse respectively. The objectives of this study were to describe Anatomic and symptomatic outcomes up to 5 years after abdominal sacrocolpopexy or sacrohysteropexy.Methods: This study was conducted in ASCOMS hospital for a cohort of patients who underwent abdominal sacrocolpopexy (ASC) or sacrohysteropexy (ASH) in 2 years (2013-2015) and follow up done for a period of 5 years from 2015-2019. These patients were evaluated for subjective and objective outcomes following ASC and ASH. women completed questionnaires and were examined in gynaecology clinic. Prospective follow up study using standarised examination with pelvic organ prolapse quantification system (POP-Q) and questionnairesResults: In the present study, there was low incidence of intraoperative and postoperative complications as well as long term complications were significantly low. The anatomical cure rate and patient satisfaction rate was both 100%.Conclusions: Abdominal sacrocolpopexy for vault prolapse and sacrohysteropexy for Nulliparous prolapse is safe and effective method and is considered gold standard for treatment of Apical compartment prolapse.
ABSTRACT
Pelvic organ prolapse is a common problem worldwide affecting parous women over 50 years of age withsignificant influence on quality of life. Sacrospinous fixation is a novel technique to treat patients ofuterovaginal prolapse and vault prolapse. This study was conducted on the patients operated withsacrospinous fixation surgery for a period of 5 years from 2012 to 2017. Their intraoperative and postoperativefindings were noted. These cases were followed up for 2-5 years after surgery to note the anatomicalcure rate and patient satisfaction rate. There was low incidence of intraoperative and postoperativecomplications. The anatomical cure rate and patient satisfaction rate was both 92% with 8% incidence offailure of procedure. Thus, Sacrospinous surgery is a safe, simple and effective method especially forcases with uterovaginal prolapse along with posterior compartment defects and vault prolapse.
ABSTRACT
Programmed labour is meant to provide pain relief and to hasten the labour process for better obstetric andneonatal outcome. It includes 3 components: active management of labour, use of obstetric analgesia anduse of partography. It was a prospective study for the patients admitted in ASCOMS hospital undergoingprogrammed labour for a period of 2 years from 2017 to 2019. A total of 50 patients underwent programmedlabour in this period. and an equal number of controls were enrolled. The duration of stages of labour,amount of pain relief and maternal and neonatal outcome was noted. In the present study, the duration offirst stage was 3.36 hrs as compared to 5.25 hours in control group which was significantly lower. Theduration of second stage of labour was also significantly lower in study group (27.2 mins vs 56.88 mins).Among the pain relief scores, 8 patients had no pain relief, 9 had mild pain relief, 14 had moderate painrelief while 19 patients had excellent pain relief. The incidence of normal vaginal delivery, LSCS andforceps/ventouse delivery were respectively 88%, 6% and 6% and neonatal outcome was also good.Programmed labour is a safe and effective technique to provide pain free labour to patients and shortenthe duration of labour without inadvertent side effects and excellent maternal and neonatal outcome.