ABSTRACT
AIMS: To evaluate long-term anatomical and functional outcomes of the transobturator-infracoccygeal hammock repair for complex genital prolapse with a porcine collagen-coated polypropylene mesh. METHODS: A prospective observational study comparing pre- and postoperative outcomes, using pelvic organ prolapse quantification (POP-Q) measurements, pelvic floor distress inventory (PFDI), and pelvic floor impact questionnaire (PFIQ) scores. RESULTS: One hundred fourteen women with recurrent, advanced, or posthysterectomy genital prolapse were enrolled. During follow-up (median value 57 months), 101 patients were available for assessment. Overall anatomical success rate was 96%, with significant improvement in quality-of-life. Three patients experienced symptomatic recurrent posterior prolapse. Seven had persistent stress urinary incontinence. Mesh exposure occurred in 6.9% of cases, including an infected hematoma that required partial excision of the mesh. No severe adverse event or change in sexual function was observed. CONCLUSIONS: The transobturator-infracoccygeal hammock is well tolerated with effective long-term anatomical and functional results for complex genital prolapse. In our experience and compared to the data of the literature, the use of collagen-coated versus uncoated polypropylene meshes seems to decrease local morbidity.
Subject(s)
Coated Materials, Biocompatible , Pelvic Organ Prolapse/surgery , Surgical Mesh , Urologic Surgical Procedures/instrumentation , Aged , Aged, 80 and over , Animals , Chi-Square Distribution , Collagen , Equipment Design , Female , France , Humans , Middle Aged , Pelvic Floor/physiopathology , Pelvic Organ Prolapse/physiopathology , Pelvic Organ Prolapse/psychology , Polypropylenes , Prospective Studies , Quality of Life , Surveys and Questionnaires , Swine , Time Factors , Treatment Outcome , Urologic Surgical Procedures/adverse effectsABSTRACT
Epidermoid cysts are benign tumors that can develop in any part of the human body. Pelvic cysts adjacent to the rectum develop rarely, and few cases have been described in the literature. We report the case of a 58-year-old woman who underwent laparoscopic and perineal excision of a giant pararectal cyst that was discovered during laparoscopy performed for preoperative provisional diagnosis of an adnexal mass detected on an imaging study. To our knowledge, this is the second case of a pararectal cyst excised using combined laparoscopic and perineal approaches. In the hands of skilled laparoscopic surgeons, we suggest a combined laparoscopic and perineal approach for excision of giant pararectal cystic tumors to avert laparotomy.
Subject(s)
Epidermal Cyst/diagnosis , Epidermal Cyst/surgery , Ovarian Cysts/diagnosis , Rectal Diseases/diagnosis , Rectal Diseases/surgery , Diagnosis, Differential , Female , Humans , Laparoscopy/methods , Middle Aged , Ovarian Cysts/surgery , Perineum/pathology , Perineum/surgery , Rectum/pathology , Rectum/surgery , Treatment OutcomeABSTRACT
The development of mucinous cystadenocarcinoma of low malignant potential in a mature cystic teratoma is rare. We report a 36-year-old single female presented with abdominal distension and was found to have a huge pelvic/abdominal mass. Ultrasound revealed a huge cystic ovarian mass with no ascites. Laparotomy and left oophorectomy was performed to the mass. Histology revealed mucinous cystadenocarcinoma of low malignant potential in a mature cystic teratoma.
