ABSTRACT
ABSTRACT BACKGROUND: Apical prolapsus refers to downward displacement of the vaginal apex, uterus or cervix. Pelvic organ prolapse (POP) can significantly affect women's daily activities and sexuality. OBJECTIVE: To investigate, at the mid-term follow-up after laparoscopic pectopexy surgery, whether this procedure improved the patients' quality of life and sexual function. DESIGN AND SETTING: In this cross-sectional study, data on patients who underwent laparoscopic pectopexy in the Gazi Yasargil Education and Research Hospital were evaluated. METHODS: Thirty-five patients with symptomatic apical prolapse and POP quantification stage II and higher were included in this study. We used the Turkish version of the female sexual function index (FSFI) questionnaire to assess preoperative and postoperative sexual dysfunction, and the Turkish version of the Prolapse Quality of Life Questionnaire (P-QOL) to evaluate the severity of POP and its impact on quality of life. RESULTS: The mean age, parity and length of follow-up of the patients were 36.08 ± 9.04 years, 4.00 ± 1.86 and 28.88 ± 5.88 months, respectively. The most common complications were de novo rectocele in three patients (8.6%) and de novo cystocele in two patients (5.7%). All the FSFI and P-QOL scores were statistically significantly improved in the postoperative period (P < 0.001 for all scores of both FSFI and P-QOL). CONCLUSION: The quality of life and sexual function of the patients who underwent laparoscopic pectopexy were found to have become statistically improved at the midterm follow-up. Laparoscopic pectopexy was found to be a viable, effective and safe procedure.
ABSTRACT
OBJECTIVE: To explore the short-term clinical effect and safety of pectopexy in the treatment of female middle pelvic defects.METHODS: Collect the clinical data and follow-up information of 32 patients,who underwent pectopexy due to pelvic prolapse with POP-Q score aboveⅡ in the Third Affiliated Hospital of Zhengzhou University and Shengjing Hospital of China Medical University from August 2018 to January 2019.The objective clinical efficacy and the results of PFDI-20 and PFIQ-7 questionnaires for pelvic floor dysfunction were evaluated by comparing the locations of Aa,Ba,Ap,Bp,C and TVL indicators of quantitative pelvic organ prolapse(POP-Q)scale before operation,1 month and 3 months after operation.RESULTS: The 32 patients completed pectopexy in 52-75 minutes,the average time being(59.22 ± 29.21)minutes;intraoperative bleeding was 10-400 mL,the average being(83.75 ± 78.89)mL;indwelling catheter days were 1-5 days,the average being(2.24±0.83)days;residual urine was 0-100 mL,the average being(32.79±29.81)mL;postoperative hospitalization days were 5-12 days,the average being(7.41±1.59)days.There was 1 case(3.13%)of asymptomatic venous thrombosis in the lower extremity during the perioperative period and 1 case(3.13%)of hypostatic pneumonia,and they were cured after active treatment.No complications occurred in the otherpatients during the perioperative period.During the follow-up period,pelvic discomfort occurred in 1 case(3.13%),which was relieved after active treatment,andno complications occurred in the rest of the patients.There was no significant difference(P>0.05)between TVL preoperatively and postoperatively at 1 and 3 months[(7.94±0.84)cm vs.(7.73±0.60)cm vs.(7.61±0.58)cm].There were significant differences in Aa[(0.94±1.92)cm vs.-(2.81±0.40)cm vs.-(2.81±0.40)cm],Ba[(2.28±2.62)cm vs.-(2.78±0.42)cm vs.-(2.78±0.42)cm],Ap[-(2.00±1.41)cm vs.-(2.92±0.26)cm vs.-(2.91±0.30)cm],Bp[-(0.91±2.78)cm vs.-(2.25±0.44)cm vs.-(2.25±0.44)cm]and C[(3.58±2.47)cm vs.-(7.72±0.58)cm vs.-(7.56±0.58)cm]among the other indicators(P<0.05).There were significant differences in PFIQ-7[(77.56±40.87)vs.(7.87±10.92)]and PFDI-20[(68.55 ± 35.05)vs.(7.66 ± 6.50)]scores before and 3 months after operation(P<0.05).CONCLUSION: Pectopexy provides new ideas and options for the treatment of pelvic defects.At present,large sample data and longterm follow-up are still needed to further observe the long-term efficacy.