Abdominal sacrohysteropexy versus vaginal hysterectomy for pelvic organ prolapse in young women

Background: Pelvic organ prolapse (POP) is the descent of the pelvic organs beyond their anatomical confines. The definitive treatment of symptomatic prolapse is surgery but its management in young is unique due to various considerations. Aim of this study was to evaluate anatomical and functional outcome after abdominal sacrohysteropexy and vaginal hysterectomy for pelvic organ prolapse in young women.Methods: A total 27 women less than 35 years of age with pelvic organ prolapse underwent either abdominal sacrohysteropexy or vaginal hysterectomy with repair. In all women, pre-op and post-op POP-Q was done for evaluation of anatomical defect and a validated questionnaire was given for subjective outcome.Results: Anatomical outcome was significant in both groups as per POP-Q grading but the symptomatic outcome was better for sacrohysteropexy with regard to surgical time, bleeding, ovarian conservation, urinary symptoms, sexual function.Conclusions: Sacrohysteropexy is a better option.

The study of the correlation between MRI staging and clinical POP-Qstaging in pelvic organ prolapse / 实用放射学杂志

Objective To assess the correlation between magnetic resonance imaging (MRI)and clinical staging of pelvic organ prolapse (POP)by using pubococcygeal line (PCL)and midpubic line (MPL)respectively.And to determine which(MRI)reference line for staging pelvic organ prolapse had the highest agreement with clinical staging.Methods A retrospective study of 32 women with pelvic organ prolapse who underwent dynamic pelvic MRI from Jan 2013 to May 2013 was conducted.One radiologist staged descent on MRI for each pelvic compartment (anterior,middle,posterior),using PCL and MPL lines.Agreement between MRI and clinical staging was estimated respectively.Results Thirty-two women were included.Agreement between clinical and MPL staging was morderate in the anterior (κ=0.44,SE=0.13)and middle compartment (κ=0.46,SE=0.12),but fair in the posterior com-partment (κ=0.23,SE=0.10).Agreement between clinical and PCL staging was poor in all compartments of pelvic.Conclusion MPL appeared more reliable and simple than the PCL for the evaluation of pelvic prolapse on MRI.

Use of Pelvic Organ Prolapse Quantification system in Korean Population Women / 대한산부인과학회잡지

OBJECTIVE: The aim of our study is to apply the Pelvic Organ Prolapse staging system to women seen for gynecologic care to generate normative data for Korean population women. METHODS: The study population considered of 486 women aged to 19 to 72 years old who seen for annual Papanicolau test and pelvic examination. Pregnant or patients within 6 weeks postpartum were not recruited. All pelvic examinations were performed by a single examiner with the subject placed in the dorsal lithotomy position by means of pelvic examination chair. All nine measurements, with the exception of total vaginal length, were taken with the patient performing maximal Valsalva maneuver. RESULTS: The subjects had a mean age of 41.3 years (range 19-72), mean parity of 1.6 (0-6) and a mean body mass index of 22.2 kg/m2 (15.7-30.9). Mean scores that described the position of the cervix, the position of the posterior forinx and the total vaginal length were as follows: C: -5.0 D: -6.6 and tvl: 7.0 cm. The overall distribution of pelvic organ prolapse quantification system stages were as follows: stage 0, 66.5%; stage 1, 21.8%; stage 2, 11.5%; and stage 3, 0.2%. No subjects examined had stage 4 prolapse. CONCLUSION: Vaginal size of Korean population women differs from that of Western population women. We are hopeful that the normative data presented in this study may provide a useful reference for physician as they evaluate prolapse an attempt to restore normal pelvic anatomy.