European journal of obstetrics, gynecology, and reproductive biology · 2022
Anterior colporrhaphy and sacrospinous hysteropexy in women with pelvic organ prolapse: Urodynamic findings and functional outcomes.
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Balsamo Raffaele, Uricchio Francesco, Costantini Elisabetta, De Sio Marco, Illiano Ester, Arcaniolo Davide, Domizio Stefano, D'Afiero Alessandro
Аннотация
OBJECTIVES: Aim of this study was to evaluate urodynamic effects and functional outcomes after anterior colporrhaphy and bilateral sacrospinous hysteropexy (SSH) in patients with stages II-IV pelvic organ prolapse (POP).
STUDY DESIGN: This is a single-centre prospective study. Sixty-two women affected by anterior/central compartment prolapse of stage II-IV u ndergoing anterior colporrhaphy and bilateral SSH were recruited from our pelvic center. The preoperative evaluation included history, clinical examination, uroflowmetry and urodynamic studies (UDS). Six months after surgery, all patients performed UDS, completed the Urogenital Distress Inventory (UDI)-6, the Incontinence Impact Questionnaire (IIQ-7) and the Patient Global Impression of Improvement (PGI-I) questionnaire.
RESULTS: Median follow-up study was 11 months (range 6-24). Q max significantly improved compared with baseline (21.1 ± 7.3 vs 12.3 ± 7.1 ml/s; p = 0.005) and the percentage of patients with PVR > 30% of premicturitional bladder volume significantly decreased (33.3% vs 11.1%; p = 0.001). At baseline, 24 (38.7%) women had typical phasic DO. Six months after surgery, DO was detected in only eleven women (17.7%) (p < 0.0001), with no de novo cases. Thirteen (21%) women reported SUI preoperatively which persisted in 5 patients (8.1%) after surgery, with no de novo cases. BOO was observed in only eight (12.9%) patients postoperatively compared with 51 (82.3%) at baseline (p < 0.0001). At last follow up visit, the UDI-6 and IIQ-7 total median scores improved significantly (p < 0.001).
CONCLUSIONS: Combination of anterior colporrhaphy and bilateral SSH in women with advanced POP provides good functional outcomes, as demonstrated by the urodynamic findings before and after surgery.
STUDY DESIGN: This is a single-centre prospective study. Sixty-two women affected by anterior/central compartment prolapse of stage II-IV u ndergoing anterior colporrhaphy and bilateral SSH were recruited from our pelvic center. The preoperative evaluation included history, clinical examination, uroflowmetry and urodynamic studies (UDS). Six months after surgery, all patients performed UDS, completed the Urogenital Distress Inventory (UDI)-6, the Incontinence Impact Questionnaire (IIQ-7) and the Patient Global Impression of Improvement (PGI-I) questionnaire.
RESULTS: Median follow-up study was 11 months (range 6-24). Q max significantly improved compared with baseline (21.1 ± 7.3 vs 12.3 ± 7.1 ml/s; p = 0.005) and the percentage of patients with PVR > 30% of premicturitional bladder volume significantly decreased (33.3% vs 11.1%; p = 0.001). At baseline, 24 (38.7%) women had typical phasic DO. Six months after surgery, DO was detected in only eleven women (17.7%) (p < 0.0001), with no de novo cases. Thirteen (21%) women reported SUI preoperatively which persisted in 5 patients (8.1%) after surgery, with no de novo cases. BOO was observed in only eight (12.9%) patients postoperatively compared with 51 (82.3%) at baseline (p < 0.0001). At last follow up visit, the UDI-6 and IIQ-7 total median scores improved significantly (p < 0.001).
CONCLUSIONS: Combination of anterior colporrhaphy and bilateral SSH in women with advanced POP provides good functional outcomes, as demonstrated by the urodynamic findings before and after surgery.