Laparoscopic Sacral Uteropexy with Cravat Technique--Experience and Results
Int. braz. j. urol
;
40(4): 526-532, Jul-Aug/2014. tab, graf
Artigo
em Inglês
| LILACS
| ID: lil-723963
ABSTRACT
Objective The aim of the present study was to evaluate the safety and efficacy of a “Cravat’’ technique for the management of uterine prolapse in patients who want to preserve uterus, involving suspension of the uterus from the sacral promontory by using polypropylene mesh. Materials and Methods A prospective observational study between January 2011 and September 2013 was conducted. Prior to surgery, prolapse assessment was undertaken with Baden-Walker halfway system to grade the degree of prolapse at all sites. Patients with severe uterine prolapse (stage II-IV) who want to preserve uterus, were operated with Cravat technique. All patients were evaluated at 2 weeks and 6 weeks after surgery and followed for 6 months. Outcomes were evaluated objectively by vaginal examination using Baden-Walker halfway classification, and subjectively classifying patients as ‘very satisfied’, ‘satisfied’ and ‘not satisfied’ at the 6th month postoperatively. Results Sacral uteropexy was successfully performed by laparoscopy in 32/33 patients (one needed to be converted to laparotomy). Nine patients also had a concurrent procedure as colporaphy anterior, colporaphy posterior or transobturator tape. Postoperative recovery has been uneventful with subjective and objective cure rates were 96.9% and 93.9%, respectively at six month. One recurrence of total prolapse needed to be reoperated and two patients with sacrouteropexy still remained at stage 2 prolapse. There have been no cases of graft exposure, rejection or infection with a median follow-up of 23.9 months. Conclusions Laparoscopic sacral uteropexy with “Cravat technique” was found to be safe and simple procedure. .
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Telas Cirúrgicas
/
Útero
/
Prolapso Uterino
/
Laparoscopia
Tipo de estudo:
Estudos de avaliação
/
Estudo observacional
Limite:
Adulto
/
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Int. braz. j. urol
Assunto da revista:
Urologia
Ano de publicação:
2014
Tipo de documento:
Artigo
País de afiliação:
Turquia
Instituição/País de afiliação:
Zeynep Kamil Maternity and Children's Training and Research Hospital/TR
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