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Surgical management of female pelvic organ prolapse with and without urinary incontinence: A single center experience

The study reports a single center experience with surgical management of female pelvic organ prolapse (POP) with and without urinary incontinence. Between January 2006 and July 2016, 93 consecutive patients with anterior and/or apical symptomatic POP underwent abdominal sacrocolpopexy (ASC) or lapar...

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Autores principales: Cormio, Luigi, Mancini, Vito, Liuzzi, Giuseppe, d’Altilia, Nicola, Carrieri, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626256/
https://www.ncbi.nlm.nih.gov/pubmed/28953613
http://dx.doi.org/10.1097/MD.0000000000007914
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author Cormio, Luigi
Mancini, Vito
Liuzzi, Giuseppe
d’Altilia, Nicola
Carrieri, Giuseppe
author_facet Cormio, Luigi
Mancini, Vito
Liuzzi, Giuseppe
d’Altilia, Nicola
Carrieri, Giuseppe
author_sort Cormio, Luigi
collection PubMed
description The study reports a single center experience with surgical management of female pelvic organ prolapse (POP) with and without urinary incontinence. Between January 2006 and July 2016, 93 consecutive patients with anterior and/or apical symptomatic POP underwent abdominal sacrocolpopexy (ASC) or laparoscopic sacrocolpopexy (LSC) or pubovaginal cystocele sling (PCS); 25 patients had concomitant stress urinary incontinence (SUI). Subjective outcome was assessed by the Pelvic Floor Impact Questionnaire (short form) (PFIQ-7) investigating bladder, bowel and vaginal functions, sexual activity, and daily life. Objective outcomes included the POP anatomic correction by Baden Walker HWS classification, urinary tract infection (UTI) rates, urge urinary incontinence (UUI), and SUI rates. Data were prospectively collected. Forty-three patients underwent PCS, 29 ASC, and 21 LSC. Mean follow-up was 54.88 ± 33.1, 28.89 ± 23.5, and 16.8 ± 11.3 months for PCS, ASC, and LSC, respectively. POP recurrence occurred in 10.5%, 7.5%, and 0% while de novo (ie, in untreated compartment/s) POP occurred in 15.8%, 7.4%, and 4.8% of patients who have undergone PCS, ASC, and LSC, respectively. Kaplan–Meier estimates of POP-free survival showed no difference among the 3 procedures. All procedures significantly reduced PFIQ-7 scores improving quality of life and the rates of recurrent UTIs and concomitant UUI. PCS cured all cases with concomitant SUI; de novo SUI occurred only in 7.4% and 4.8% of patients who have undergone ASC and LSC, respectively. Mean surgical time was significantly shorter for PCS compared to ASC and LSC (P = .0001), and for ASC compared to LSC (P = .004); there was no difference in postoperative pain and hospital stay. Compared to ASC/LSC, PCS involved a higher rate (27.9% vs 6%; P = .01) of minor complications, mainly transient urinary retention, and a lower rate (0% vs 8%; P = .06) of complications requiring surgery. In this single center experience, PCS was not only provided similar subjective and objective results than ASC and LSC but also able to correct concomitant SUI without causing de novo SUI and was safer than other 2 techniques, in female POP repair.
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spelling pubmed-56262562017-10-11 Surgical management of female pelvic organ prolapse with and without urinary incontinence: A single center experience Cormio, Luigi Mancini, Vito Liuzzi, Giuseppe d’Altilia, Nicola Carrieri, Giuseppe Medicine (Baltimore) 7300 The study reports a single center experience with surgical management of female pelvic organ prolapse (POP) with and without urinary incontinence. Between January 2006 and July 2016, 93 consecutive patients with anterior and/or apical symptomatic POP underwent abdominal sacrocolpopexy (ASC) or laparoscopic sacrocolpopexy (LSC) or pubovaginal cystocele sling (PCS); 25 patients had concomitant stress urinary incontinence (SUI). Subjective outcome was assessed by the Pelvic Floor Impact Questionnaire (short form) (PFIQ-7) investigating bladder, bowel and vaginal functions, sexual activity, and daily life. Objective outcomes included the POP anatomic correction by Baden Walker HWS classification, urinary tract infection (UTI) rates, urge urinary incontinence (UUI), and SUI rates. Data were prospectively collected. Forty-three patients underwent PCS, 29 ASC, and 21 LSC. Mean follow-up was 54.88 ± 33.1, 28.89 ± 23.5, and 16.8 ± 11.3 months for PCS, ASC, and LSC, respectively. POP recurrence occurred in 10.5%, 7.5%, and 0% while de novo (ie, in untreated compartment/s) POP occurred in 15.8%, 7.4%, and 4.8% of patients who have undergone PCS, ASC, and LSC, respectively. Kaplan–Meier estimates of POP-free survival showed no difference among the 3 procedures. All procedures significantly reduced PFIQ-7 scores improving quality of life and the rates of recurrent UTIs and concomitant UUI. PCS cured all cases with concomitant SUI; de novo SUI occurred only in 7.4% and 4.8% of patients who have undergone ASC and LSC, respectively. Mean surgical time was significantly shorter for PCS compared to ASC and LSC (P = .0001), and for ASC compared to LSC (P = .004); there was no difference in postoperative pain and hospital stay. Compared to ASC/LSC, PCS involved a higher rate (27.9% vs 6%; P = .01) of minor complications, mainly transient urinary retention, and a lower rate (0% vs 8%; P = .06) of complications requiring surgery. In this single center experience, PCS was not only provided similar subjective and objective results than ASC and LSC but also able to correct concomitant SUI without causing de novo SUI and was safer than other 2 techniques, in female POP repair. Wolters Kluwer Health 2017-09-29 /pmc/articles/PMC5626256/ /pubmed/28953613 http://dx.doi.org/10.1097/MD.0000000000007914 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0
spellingShingle 7300
Cormio, Luigi
Mancini, Vito
Liuzzi, Giuseppe
d’Altilia, Nicola
Carrieri, Giuseppe
Surgical management of female pelvic organ prolapse with and without urinary incontinence: A single center experience
title Surgical management of female pelvic organ prolapse with and without urinary incontinence: A single center experience
title_full Surgical management of female pelvic organ prolapse with and without urinary incontinence: A single center experience
title_fullStr Surgical management of female pelvic organ prolapse with and without urinary incontinence: A single center experience
title_full_unstemmed Surgical management of female pelvic organ prolapse with and without urinary incontinence: A single center experience
title_short Surgical management of female pelvic organ prolapse with and without urinary incontinence: A single center experience
title_sort surgical management of female pelvic organ prolapse with and without urinary incontinence: a single center experience
topic 7300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626256/
https://www.ncbi.nlm.nih.gov/pubmed/28953613
http://dx.doi.org/10.1097/MD.0000000000007914
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