Střednědobé výsledky chirurgické léčby recidivující cystokély po hysterektomii s využitím transvaginálního implantátu
| Title in English | Mid-term surgical treatment results of anchored implant use in recurrent cystocele treatment after previous hysterectomy |
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| Authors | |
| Year of publication | 2019 |
| Type | Article in Periodical |
| Magazine / Source | CESKA GYNEKOLOGIE-CZECH GYNAECOLOGY |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.prolekare.cz/casopisy/ceska-gynekologie/2019-2-12/strednedobe-vysledky-chirurgicke-lecby-recidivujici-cystokely-po-hysterektomii-s-vyuzitim-transvaginalniho-implantatu-112793 |
| Keywords | descent of pelvic organs; cystocele; transvaginal implant; complications |
| Description | Objective: The main aim of this study was to evaluate the safety and mid-term efficacy of reconstructing of recurrent cystocele after previous hysterectomy using a transvaginal mesh (TVM). The secondary aim was to compare the obtained results with literary data. Design: Prospective observational study. Setting: Department of Obstetrics and Gynecology. Masaryk University, University Hospital Brno. Methods: Patients after hysterectomy with recurrent pelvic organ prolapse (POP) of cystocele stage 3-4 according to the POP-Q (Pelvic Organ Prolapse Quantification System) were surgically treated with the introduction of TVM Calistar A (Promedon) at the Urogynecology Center between years 2012-2015. The severity of the POP symptoms was evaluated using the standardized Pelvic Organ Prolapse Distress Inventory questionnaire (POPDI-6). Two years after surgery, patients underwent a subjective and objective assessment of the effectiveness of surgical performance. Objective success of treatment was defined as a POP-Q stages 2 during a standardized vaginal examination. Subjective satisfaction was re-evaluated using the POPDI-6 ques tionnaire. In order to evaluate the patient's satisfaction with the success of treatment, a general patient satisfaction with treatment scale (Patient Global Impression of Improvement) was used. Results: A total of 39 women (81.3%) attended the evaluation after two years. A total of 33 patients (84.6%) were satisfied with the result of the surgery. An objective success of treatment was found in 30 women (76.9%). In four cases (10.3%), the protrusion of the implant was found. Three women underwent reoperation for the relapse of the POP (7.7%). Conclusion: Medium-term results of reconstruction of recurrent cystocele using TVM are satisfactory; the percentage of objectively cured patients was slightly lower than their subjective satisfaction. Compared to the findings of the latest Cochrane Reviews and literary data evaluating POP's surgical treatment, our results were comparable or better. |