[Laparoscopic Y-shaped polypropylene mesh for uterine and vaginal vault prolapse].

Abstract

OBJECTIVE:

To investigate the effectiveness oflaparoscopic Y-shaped polypropylene mesh in the treatment of uterine and vaginal vault prolapse.

METHODS:

Between June 2010 and December 2012, 24 patients with uterine and vaginal vault prolapse were treated by laparoscopic pelvic reconstruction (vagina and uterus-sacral fixation) with Y-shaped polypropylene mesh. The age of patients was 35-60 years (mean, 48.6 years). The disease duration was 2-8 years (mean, 5 years). According to the pelvic organ prolapse quatitative (POP-Q) classification by International Continence Society (ICS), 16 cases were classified as uterine prolapsed degree II and 8 cases as degree III; 15 cases were classified as vaginal prolapse degree I, 7 cases as degree II, and 2 cases as degree III. All patients received postoperative follow-up regularly. Subjective evaluation was done based on prolapse quality of life questionnaire (P-QOL), and objective evaluation based on POP-Q classification.

RESULTS:

All the patients were operated successfully. The operation time was 22-68 minutes (mean, 33 minutes); the blood loss was 30-80 mL (mean, 51 mL); the indwelling urethral catheter remain was 3-7 days (mean, 4 days); and the hospitalization days were 4-9 days (mean, 6.8 days). Twenty-four patients were followed up 3-12 months (mean, 9 months), of whom, 2 were followed up less than 6 months. All patients had normal urination after withdrawal of urethral catheter, and the residual urine volume was in normal range. No patients had mesh erosion and discomfort during sex, vaginal and anal bearing down. The P-QOL scores at 3, 6, and 12 months after operation were significantly improved when compared with the preoperative value (P < 0.05); but there was no significant difference among 3, 6, and 12 months after operation (P > 0.05). The postoperative POP-Q classification was degree 0 in 19 cases and degree I in 3 cases, and the objective cure rate was 91.7%. No recurrence was found during followup.

CONCLUSION:

Laparoscopic Y-shaped polypropylene mesh for treatment of uterine and vaginal vault prolapse is a safe and effective method, especially applicable to preserve the uterus, and higher requirements of sexual life of patients.

• Authors: Min Li, Yichen Feng, Shaoyan Jin, Danhua Yu
• Journal: Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery (Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi) Vol. 27 Issue 9 Pg. 1106-9 (Sep 2013) ISSN: 1002-1892 [Print] China
• PMID: 24279025 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Polypropylenes

Topics

• Adult
• Female
• Follow-Up Studies
• Gynecologic Surgical Procedures (instrumentation, methods)
• Humans
• Laparoscopy (methods)
• Middle Aged
• Pelvic Organ Prolapse (pathology, surgery)
• Polypropylenes
• Quality of Life
• Severity of Illness Index
• Surgical Mesh
• Treatment Outcome
• Uterine Prolapse (pathology, surgery)