Transvaginal Prosima mesh and high uterosacral ligament suspension in the treatment of severe pelvic organ prolapsey

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Author:
WANG Wen-ying(Department of Obstetrics and Gynecology,First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048,China)
NIU Ke(Department of Obstetrics and Gynecology,First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048,China)
LU Yong-xian(Department of Obstetrics and Gynecology,First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048,China)
HU Xiao-juan()
LIU Xin(Department of Obstetrics and Gynecology,First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048,China)
SHEN Wen-jie(Department of Obstetrics and Gynecology,First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048,China)
LIU Jing-xia(Department of Obstetrics and Gynecology,First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048,China)
GE Jing(Department of Obstetrics and Gynecology,First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048,China)
ZHANG Ying-hui(Department of Obstetrics and Gynecology,First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048,China)
ZHAO Ying(Department of Obstetrics and Gynecology,First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing 100048,China)
Journal Title:
Chinese Journal of Obstetrics and Gynecology
Issue:
Volume 47, Issue 07, 2012
DOI:
10.3760/cma.j.issn.0529-567x.2012.07.006
Key Word:
Pelvic ogang prolapse; Gynecologic surgical procedures; Pelvis

Abstract: Objective To study the efficacy of performing transvaginal Prosima mesh with high uterosacral ligament suspension (HUS) in treatment of severe pelvic organ prolapse (POP).Methods From July 2010 to February 2011,70 patients with severe POP underwent transvaginal prosima mesh with HUS in First Affiliated Hospital,General Hospital of People's Liberation Army.Clinical parameters of perioperation were collected.After 1 month and 2 - 3 months,perineal two-dimensional ultrasound examination was performed to measure mesh length in midsagittal plane.Validated prolapse quality of life questionnaires,pelvic floor distress inventsry short form 20 (PFDI-20) and pelvic floor impact questionnaire short form 7 (PFIQ-7) were used to evaluate the therapeutic effect.The mean results of pre-operative PFIQ-7 and PFDI-20 was 54 and 51,respectively.Results Median operation time was ( 195 ± 47 ) min and median blood loss was (160 ±64) ml.All the patients were followed for a mean time of 13 months (2 - 19 months).Seven cases were found with mesh exposure with less than 1 cm2.The objective cure rate was 100%.The mean score of post-operative PFIQ-7 and PFDI-20 were both 19,which were significantly lower than those of preoperation ( P < 0.05 ).Anterior Prosima mesh was 3.5 cm at 1 month by ultrasound examination,and the second result of ultrasound scans was 2.8 cm at 2 - 3 month,which were both shortened 2.5 cm and 3.2 cm when compared with that of original size.Conclusions Transvaginal Prosima mesh placement with HUS is a safe and efficient surgery with less complication.Although mesh became shorter after 2 - 3 month,it did not affect surgery efficacy.

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