Modified total pelvic floor reconstruction for repair of severe pelvic organ prolapse / 中国医学科学院学报

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the clinical outcome of a novel approach for pelvic floor reconstruction using synthetic mesh (modified total pelvic floor reconstruction) for treatment of pelvic organ prolapse.</p><p><b>METHODS</b>Modified total pelvic floor reconstruction was performed in 30 patients with severe pelvic organ prolapse (including vault prolapse). The clinical outcome of each patient was assessed.</p><p><b>RESULTS</b>The mean operation time was (74.2 +/- 21.5) minutes, and the mean blood loss was (103.3 +/- 40.1) ml. Among them, 23 patients (76.7%) were able to micturate spontaneously the next morning after surgery, with residual urine less than 100 ml. The mean post-operative hospital stay was (4.2 +/- 1.8) days. All patients were followed up for a medium of 6 months. Totally 93.3% and 96.7% of patients were objectively (according to Pelvic Organ Prolapse Quantitive Examination score) and subjectively (according to Prolapse Quality of Life) cured, respectively. During follow-up, only one patient was found to have asymptomatic erosion, and de novo urgent urinary incontinence was seen in 6.7% of patients. The most prominent complication was dyspareunia (66.7%). Although the post-operative sexual function was reported to be worse, no significant difference between patients' pre- and post-operative Pelvic Organ Prolapse/ Urinary Incontinence Sexual Function Questionnaire-12 scores was noted.</p><p><b>CONCLUSION</b>Modified total pelvic floor reconstruction is a safe, effective, and micro-invasive approach for severe pelvic organ prolapse repair; however, dyspareunia remains a main concern.</p>