Total pelvic organ prolapses and its surgery with meses: Adventure or cure?

Abstract

Total pelvic organ prolapse is a condition that is frequently seen in elderly women and presents with defecation and urinary system dysfunctions and impairs quality of life. Study objective: While preparing this study with its results, our aim was to evaluate the positive effect of minimally invasive repair with mesh on impaired organ functions, anatomy and quality of life in patients with obvious pelvic organ prolapse. Design: Among the people who applied to the gynecology and proctology outpatient clinic within a certain time period, the files of the patients with complaints stated below were scanned. The determined parameters were collected and evaluated prospectively. Statistical study was done with SPSS 15.0. Patients: The patients were those who applied to the gynecology and proctology outpatient clinic. Patients with complaints of vaginal/pelvic fullness, constipation, fecal incontinence, and prominent vaginal tissue prolapse between the legs were selected to participate in the study. Measurement and main results: Laparoscopic promontofixation was performed on 8 patients with overt pelvic organ prolapse (POP-Q III and IV), among those who applied to the outpatient clinic with complaints of pelvic fullness, pain, difficult urinating, constipation or overt organ prolapse between 2015-19. Pelvic dysfunction, difficult urination and defecation function of these patients were evaluated. Pelvic organ distress, urinary distress, and colorectal distress inventory questionnaires were administered to the patients before and during follow-up and the measurements were compared. Complications related to surgery and recurrence was also monitored during follow-up. In those patients followed for an average of 29.5 months. Surgical recurrence was observed in one patient and various surgical complications were observed in 4/8 patients. At the end of the comparative evaluation of the questionnaires, it was determined that the patients’ pelvic function and difficult urination improved with surgery. However, an improvement could not be demonstrated in defecation function. Conclusion: Laparoscopic promontofixation should be kept in mind as a surgical method that can provide functional improvement in selected patients with overt pelvic organ prolapse.