Effectiveness of the choice of the optimal method for surgical treatment of genital prolapse

Abstract

AIM: This study aimed to evaluate the effectiveness of the choice of surgical method for treating genital prolapse, depending on the intensity of pelvic floor tissue perfusion.

MATERIALS AND METHODS: The study assessed the relationship of extragenital pathology, medical history of women operated for genital prolapse and medical history of women without genital prolapse during peri- and post-menopause (control group, n=67) with indicators of vaginal perfusion intensity. Overall, 328 patients with pelvic organ prolapse (II–IV degree) underwent surgery according to the Pelvic Organ Prolapse Quantification system. Of these, 287 patients were examined after 2 years to diagnose disease recurrence; these patients were included in the main study group (n=287). For statistical processing of the obtained results, the STATISTICA 10.0 and EViews 12.0 software packages were used.

RESULTS: Correlation analysis revealed an inverse relationship between vaginal microcirculation intensity with age (r_s=−0.187; р=0.025), menopause duration (r_s=−0.390; р=0.001), genital prolapse duration (r_s=−0.245; р=0.046), and surgical menopause (r_s=−0.442; р <0.001). The study of microcirculation intensity in the anterior and posterior vaginal walls, depending on the presence of somatic diseases, revealed an inverse correlation with diseases such as hypertension (r_s=−0.291; р <0.001), coronary heart disease (r_s=−0.169; р=0.044), and diabetes mellitus (r_s=−0.223; р=0.008). When choosing a method of surgical treatment that minimizes the contact of mesh prosthesis with native tissues in women with comorbid pathology, a relapse of the disease after 2 years was detected in only 2.4% women.

CONCLUSION: The choice of the optimal method for treatment in patients with somatic burden and low perfusion capacity of pelvic organs and tissues can reduce the number of complications after surgical treatment of pelvic prolapse.

Keywords

pelvic organ prolapse / pelvic floor / hypertension / diabetes mellitus / obesity / surgery

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