An original method of surgical correction of enterocele using a titanium implant with transobturator-sacrospinal fixation

Abstract

AIM: This study aimed to optimize the outcomes of surgical treatment of enterocele using the original model of “titanium silk” mesh implants with their transobturator-sacrospinal fixation.

MATERIALS AND METHODS: A comprehensive clinical examination and surgical treatment of 22 patients aged 53–68 years with enterocele who had undergone surgical interventions for various forms of POP, were conducted. All patients underwent surgery using the surgical technique developed for enterocele correction using an original “titanium silk” mesh implant model with transobturator-sacrospinal fastening. Outpatient monitoring of patients in the early and delayed postoperative periods was carried out after 1, 6, 12, and 24 months.

RESULTS: During dynamic follow-up, patients were satisfied with the results of the surgical treatment, POP symptoms were stable, and no signs of relapse and mesh-associated complications were observed.

CONCLUSION: The study confirmed the effectiveness and safety of a new surgical technique for enterocele correction using an original model of a mesh implant “titanium silk” with transobturator-sacrospinal fixation in patients with enterocele who had undergone surgery in the past for various forms of POP. However, further research in this direction is needed.

Keywords

pelvic organ prolapse / enterocele / mesh implant “Titanium silk” / titanium “anchor” ligature fixators in soft tissues

References

[1] Ischenko АА, Аleksandrov LS, Hokhlova ID, et al. A New Method of Surgical Enterocele Correction Using Mesh Implants. Sovremennye tehnologii v medicine. 2017;9(3):77–81. doi: 10.17691/stm2017.9.3.10

[2] Ищенко А.А., Александров Л.С., Хохлова И.Д., и др. Новый способ хирургической коррекции энтероцеле с помощью сетчатых имплантатов // Современные технологии в медицине. 2017. Т. 9, № 3. С. 77–81. doi: 10.17691/stm2017.9.3.10

[3] Ischenko АА, Аleksandrov LS, Hokhlova ID, et al. A New Method of Surgical Enterocele Correction Using Mesh Implants. Sovremennye tehnologii v medicine. 2017;9(3):77–81. doi: 10.17691/stm2017.9.3.10

[4] Perov YV, Popova IS, Bykov AV. Enterocele. Novosti Khirurgii. 2020;28(4):439–448. doi: 10.18484/2305-0047.2020.4.439

[5] Перов Ю.В., Попова И.С., Быков А.В. Энтероцеле // Новости хирургии. 2020. Т. 28, № 4. С. 439–448. doi: 10.18484/2305-0047.2020.4.439

[6] Perov YV, Popova IS, Bykov AV. Enterocele. Novosti Khirurgii. 2020;28(4):439–448. doi: 10.18484/2305-0047.2020.4.439

[7] Buianova SN, Shchukina NA, Zubova ES, Sibryaeva VA, Rizhinashvili ID. Genital prolapse. Russian Bulletin of Obstetrician-Gynecologist. 2017;17(1):37–45. doi: 10.17116/rosakush201717137-45

[8] Буянова С.Н., Щукина Н.А., Зубова Е.С., Сибряева В.А., Рижинашвили И.Д. Пролапс гениталий // Российский вестник акушера-гинеколога. 2017. Т. 17, № 1. С. 37–45. doi: 10.17116/rosakush201717137-45

[9] Buianova SN, Shchukina NA, Zubova ES, Sibryaeva VA, Rizhinashvili ID. Genital prolapse. Russian Bulletin of Obstetrician-Gynecologist. 2017;17(1):37–45. doi: 10.17116/rosakush201717137-45

[10] The Russian Society of Obstetricians and Gynecologists, the All-Russian public organization "Russian Society of Urologists". Clinical recommendations "Prolapse of female genital organs". Approved by the Ministry of Health of the Russian Federation. Moscow; 2021. (In Russ.)

[11] Российское общество акушеров-гинекологов, Общероссийская общественная организация «Российское общество урологов». Клинические рекомендации «Выпадение женских половых органов». Одобрено Минздравом РФ. Москва, 2021.

[12] The Russian Society of Obstetricians and Gynecologists, the All-Russian public organization "Russian Society of Urologists". Clinical recommendations "Prolapse of female genital organs". Approved by the Ministry of Health of the Russian Federation. Moscow; 2021. (In Russ.)

[13] Strizhakov AN, Kosachenko AG, Davydov AI. Genital hernias. The current state of the problem. Gynecology, Obstetrics and Perinatology. 2016;15(1):58–64. doi: 10.20953/1726-1678-2016-1-58-64

[14] Стрижаков А.Н., Косаченко А.Г., Давыдов А.И. Генитальные грыжи. Современное состояние проблемы // Вопросы гинекологии, акушерства и перинатологии. 2016. Т. 15, № 1. С. 58–64. doi: 10.20953/1726-1678-2016-1-58-64

[15] Strizhakov AN, Kosachenko AG, Davydov AI. Genital hernias. The current state of the problem. Gynecology, Obstetrics and Perinatology. 2016;15(1):58–64. doi: 10.20953/1726-1678-2016-1-58-64

[16] Ishchenko AI, Shulchina IV, Ishchenko AA, Zhumanova EN, Gorbenko OYu. Mesh-associated complications. Risk factors. V.F. Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):4–7. (In Russ.)

[17] Ищенко А.И., Шульчина И.В., Ищенко А.А., Жуманова Е.Н., Горбенко О.Ю. Mesh-ассоциированные осложнения. Факторы риска // Архив акушерства и гинекологии им. В.Ф. Снегирева. 2014. Т. 1, № 2. С. 4–7.

[18] Ishchenko AI, Shulchina IV, Ishchenko AA, Zhumanova EN, Gorbenko OYu. Mesh-associated complications. Risk factors. V.F. Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):4–7. (In Russ.)

[19] Barinova EK, Aryutin DG, Ordiyants EG, et al. Mesh-associated complications in gynecology. Obstetrics and Gynecology: News, Opinions, Training. 2021;9(3 suppl.):102–107. doi: 10.33029/2303-9698-2021-9-3suppl-102-107

[20] Баринова Э.К., Арютин Д.Г., Ордиянц Е.Г., и др. Mesh-ассоциированные осложнения в гинекологии // Акушерство и гинекология: новости, мнения, обучение. 2021. Т. 9, № 3 (приложение). С. 102–107. doi: 10.33029/2303-9698-2021-9-3suppl-102-107

[21] Barinova EK, Aryutin DG, Ordiyants EG, et al. Mesh-associated complications in gynecology. Obstetrics and Gynecology: News, Opinions, Training. 2021;9(3 suppl.):102–107. doi: 10.33029/2303-9698-2021-9-3suppl-102-107

[22] Patent RUS № 2597409 C2/ 10.09.16. Byul. № 25. Ishshenko AI, Ishshenko AA, Gorbenko OYu, Kolgaeva DI. Method for surgical treatment of vaginal enterocele, rectocele. Available from: https://yandex.ru/patents/doc/RU2597409C2_20160910?ysclid=luzweguvej920008178 (In Russ.) EDN: TLOONL

[23] Патент РФ на изобретение № 2597409 C2/10.09.16. Бюл. № 25. Ищенко А.И., Ищенко А.А., Горбенко О.Ю., Колгаева Д.И. Способ хирургического лечения влагалищного энтероцеле, ректоцеле. Режим доступа: https://yandex.ru/patents/doc/RU2597409C2_20160910?ysclid=luzweguvej920008178 Дата обращения: 14.04.2024. EDN: TLOONL

[24] Patent RUS № 2597409 C2/ 10.09.16. Byul. № 25. Ishshenko AI, Ishshenko AA, Gorbenko OYu, Kolgaeva DI. Method for surgical treatment of vaginal enterocele, rectocele. Available from: https://yandex.ru/patents/doc/RU2597409C2_20160910?ysclid=luzweguvej920008178 (In Russ.) EDN: TLOONL

[25] Roos EJ, Schuit E. Timing of recurrence after surgery in pelvic organ prolapsed. Int Urogynecol J. 2021;32(8):2169–2176. doi: 10.1007/s00192-021-04754-6

[26] Roos E.J., Schuit E. Timing of recurrence after surgery in pelvic organ prolapse // Int Urogynecol J. 2021. Vol. 32, N 8. P. 2169–2176. doi: 10.1007/s00192-021-04754-6

[27] Roos EJ, Schuit E. Timing of recurrence after surgery in pelvic organ prolapsed. Int Urogynecol J. 2021;32(8):2169–2176. doi: 10.1007/s00192-021-04754-6

[28] Ward RM, Velez Edwards DR, Edwards T, et al. Genetic epidemiology of pelvic organ prolapse: a systematic review. Am J Obstet Gynecol. 2014;211(4):326–335. doi: 10.1016/j.ajog.2014.04.006

[29] Ward R.M., Velez Edwards D.R., Edwards T., et al. Genetic epidemiology of pelvic organ prolapse: a systematic review // Am J Obstet Gynecol. 2014. Vol. 211, N 4. P. 326–335. doi: 10.1016/j.ajog.2014.04.006

[30] Ward RM, Velez Edwards DR, Edwards T, et al. Genetic epidemiology of pelvic organ prolapse: a systematic review. Am J Obstet Gynecol. 2014;211(4):326–335. doi: 10.1016/j.ajog.2014.04.006

[31] Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214. Obstet Gynecol. 2019;134(5):e126–e142. doi: 10.1097/AOG.0000000000003519

[32] Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214 // Obstet Gynecol. 2019. Vol. 134, N 5. P. e126–e142. doi: 10.1097/AOG.0000000000003519

[33] Pelvic Organ Prolapse: ACOG Practice Bulletin, Number 214. Obstet Gynecol. 2019;134(5):e126–e142. doi: 10.1097/AOG.0000000000003519

[34] Guzman-Negron JM, Fascelli M, Vasavada SP. Posterior Vaginal Wall Prolapse: Suture-Based Repair. Urol Clin North Am. 2019;46(1):79–85. doi: 10.1016/j.ucl.2018.08.007

[35] Guzman-Negron J.M., Fascelli M., Vasavada S.P. Posterior Vaginal Wall Prolapse: Suture-Based Repair // Urol Clin North Am. 2019. Vol. 46, N 1. P. 79–85. doi: 10.1016/j.ucl.2018.08.007

[36] Guzman-Negron JM, Fascelli M, Vasavada SP. Posterior Vaginal Wall Prolapse: Suture-Based Repair. Urol Clin North Am. 2019;46(1):79–85. doi: 10.1016/j.ucl.2018.08.007

[37] Milani R, Manodoro S, Cola A, et al. Transvaginal native-tissue repair of enterocele. Int Urogynecol J. 2018;29(11):1705–1707. doi: 10.1007/s00192-018-3686-3

[38] Milani R., Manodoro S., Cola A., et al. Transvaginal native-tissue repair of enterocele // Int Urogynecol J. 2018. Vol. 29, N 11. P. 1705–1707. doi: 10.1007/s00192-018-3686-3

[39] Milani R, Manodoro S, Cola A, et al. Transvaginal native-tissue repair of enterocele. Int Urogynecol J. 2018;29(11):1705–1707. doi: 10.1007/s00192-018-3686-3

[40] Khitaryan AG, Miziev IA, Dul’erov KA, Pogosyan AA, Provotorov ME. The tactics of surgical reconstruction of the pelvic floor in women with rear prolapse of pelvic organs. Russian Journal of Surgery. 2013;(1):31–36.

[41] Хитарьян АГ, Мизиев И.А., Дульеров К.А., Погосян А.А., Провоторов М.Е. Тактика хирургической реконструкции тазового дна у женщин с задним пролапсом тазовых органов // Анналы хирургии. 2013. № 1. C. 31–36.

[42] Khitaryan AG, Miziev IA, Dul’erov KA, Pogosyan AA, Provotorov ME. The tactics of surgical reconstruction of the pelvic floor in women with rear prolapse of pelvic organs. Russian Journal of Surgery. 2013;(1):31–36.

[43] Ahmad M, Sileri P, Franceschilli L, Mercer-Jones M. The role of biologics in pelvic floor surgery. Colorectal Dis. 2012;14 Suppl.3:19–23. doi: 10.1111/codi.12045

[44] Ahmad M., Sileri P., Franceschilli L., Mercer-Jones M. The role of biologics in pelvic floor surgery // Colorectal Dis. 2012. Vol. 14, Suppl. 3. P. 19–23. doi: 10.1111/codi.12045

[45] Ahmad M, Sileri P, Franceschilli L, Mercer-Jones M. The role of biologics in pelvic floor surgery. Colorectal Dis. 2012;14 Suppl.3:19–23. doi: 10.1111/codi.12045

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