Laparoscopic correction of combined forms of genital prolapse

Abstract

BACKGROUND: The significance of pelvic organ prolapse is determined by the absence of a downward trend in its frequency and severity and by the steadily high number of recurrences in every third woman who underwent surgery. According to most authors, surgical correction is the primary treatment for genital prolapse. Therefore, the search for an effective and safe surgical treatment of this pathology is important. Currently, various minimally invasive surgical interventions have been performed via laparoscopic access, which reduces the risk of tissue or adjacent organ damage, possible intraoperative bleeding, and potential complications.

AIM: This study aimed to assess the efficiency and safety of laparoscopic techniques for the correction of genital prolapse.

MATERIALS AND METHODS: The study included 12 patients with pelvic organ prolapse quantification system grades II–IV who underwent surgical correction using a combined laparoscopic approach. The inclusion criterion was the presence of prolapse, including recurrent forms. At the outpatient stage, the patients’ medical history was collected, and complaints, and degree of pelvic organ prolapse were assessed. Genital prolapse was diagnosed based on medical history, clinical data, and additional methods of examination.

RESULTS: With this surgical intervention technique, intraoperative bleeding was avoided, the number of possible postoperative complications was reduced, and disease recurrence was prevented. The criteria for assessing the surgical intervention included improvement of the pelvic floor anatomy, elimination of symptoms, patient’s satisfaction with treatment results and quality of life, and reduced risk of recurrence of complications. Mesh-associated complications were excluded by avoiding contact of the synthetic implanted material with the vaginal mucosa.

CONCLUSIONS: Through laparoscopic access, the length of hospital stay was reduced, and compared with abdominal access, a better cosmetic effect was achieved. A comprehensive system considering the assessment of the anatomical outcome, functional status of the pelvic floor, and patient’s quality of life may become the most objective tool to evaluate the success of surgical treatment of genital prolapse.

Keywords

genital prolapse / laparoscopy / combined laparoscopic access / mesh materials / surgical treatment of genital prolapse / laparoscopic sacroovaginopexy / laparoscopic pectopexy / laparoscopic pectovaginopexy

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