Surgical Management of Female Pelvic Organ Prolapse with and Without Urinary Incontinence

Data were prospectively collected. Forty-three patients underwent PCS, 29 ASC, and 21 LSC. Mean follow-up was 54.88 ± 33.1, 28.89 ± 23.5, and 16.8 ± 11.3 months for PCS, ASC, and LSC, respectively.

Surgical Management of Female Pelvic Organ Prolapse with and Without Urinary Incontinence

Surgical Management of Female Pelvic Organ Prolapse with and Without Urinary Incontinence

Abstract : Abstract: The study reports a single center experience with surgical management of female pelvic organ prolapse (POP) with and without urinary incontinence. Between January 2006 and July 2016, 93 consecutive patients with anterior and/or apical symptomatic POP underwent abdominal sacrocolpopexy (ASC) or laparoscopic sacrocolpopexy (LSC) or pubovaginal cystocele sling (PCS); 25 patients had concomitant stress urinary incontinence (SUI). Subjective outcome was assessed by the Pelvic Floor Impact Questionnaire (short form) (PFIQ-7) investigating bladder, bowel and vaginal functions, sexual activity, and daily life. Objective outcomes included the POP anatomic correction by Baden Walker HWS classification, urinary tract infection (UTI) rates, urge urinary incontinence (UUI), and SUI rates. Data were prospectively collected. Forty-three patients underwent PCS, 29 ASC, and 21 LSC. Mean follow-up was 54.88 ± 33.1, 28.89 ± 23.5, and 16.8 ± 11.3 months for PCS, ASC, and LSC, respectively. POP recurrence occurred in 10.5%, 7.5%, and 0% while de novo (ie, in untreated compartment/s) POP occurred in 15.8%, 7.4%, and 4.8% of patients who have undergone PCS, ASC, and LSC, respectively. Kaplan–Meier estimates of POP-free survival showed no difference among the 3 procedures. All procedures significantly reduced PFIQ-7 scores improving quality of life and the rates of recurrent UTIs and concomitant UUI. PCS cured all cases with concomitant SUI; de novo SUI occurred only in 7.4% and 4.8% of patients who have undergone ASC and LSC, respectively. Mean surgical time was significantly shorter for PCS compared to ASC and LSC ( P = .0001), and for ASC compared to LSC ( P = .004); there was no difference in postoperative pain and hospital stay. Compared to ASC/LSC, PCS involved a higher rate (27.9% vs 6%; P = .01) of minor complications, mainly transient urinary retention, and a lower rate (0% vs 8%; P = .06) of complications requiring surgery. In this single center experience, PCS was not only provided similar subjective and objective results than ASC and LSC but also able to correct concomitant SUI without causing de novo SUI and was safer than other 2 techniques, in female POP repair.

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Cumulated Index Medicus
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Surgical Management of Pelvic Organ Prolapse is the ideal way to enhance your surgical skills in this key area of gynecology, urogynecology, and urology. In this volume in the Female Pelvic Surgery Video Atlas Series, written by series editor Mickey Karram, MD, detailed discussions and illustrations, case studies, and video
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Enhance your clinical success with practice-proven guidance! This trusted and tested reference provides complete, timely, and easy access to vital information on the medical and surgical issues affecting todays daily gynecology practice. Featuring the fresh perspectives of four new editors, along with new contributors, the text offers practical, in-depth coverage...helpful
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Edited and authored by some of the most respected figures in the field, this newly revised book is your comprehensive guide to all areas of urogynecology, including urinary and fecal incontinence, urodynamic testing, management of genuine stress incontinence, pelvic organ prolapse, overactive bladder, and much more. Uniquely organized to reflect

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