Long-term results of extraperitoneal vaginopexy (Prolift surgery): prospective research

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The aim of the study was to analyze long-term anatomical and functional results, quality of life and rate of complications after extraperitoneal vaginopexy (Prolift surgery). Over the period of time from November 2005 to December 2009 three experienced surgeons operated on 239 patients. Prolift Anterior surgery was performed in 69 patients, 21 patients underwent Prolift Posterior surgery, 149 patients - Prolift Anterior et Posterior (in case of preserved uterus) or Prolift Total (in patients after hysterectomy) surgery. Anatomic result was considered to be successful in case of operated pelvic floor portion prolapse 0 or I stage due to Pelvic Organ Prolapse Quantification (POP-Q) without need of repeated operation 1 year after the surgery. As part of the study patients were interviewed, had gynecological exam, intensity of symptoms and quality of life were analysed by means of standard questionnaires before, 6 and 12 months after the surgery. A year after the surgery 203 (85%) patients attended second medical appointment, 177 (87.2%) of them had satisfactory anatomical results. Patients after Prolift Anterior surgery had the worst results. Functional results significantly improved a year after. As for intraoperative complications bladder injury was observed in 1 case, rectum injury in 3 cases, mild hemorrhage in 4 cases was managed by ligation. Vaginal erosion, predominantly on the anterior wall, was noted in 27 (11.3%) patients. Application of Prolift surgery for prolapse treatment demonstrated good results during 1 year follow-up, low rate of intra- and postoperative complications. Considering high rate of intact components prolapse (de novo) total pelvic floor correction should have been done. Further comparative researches, evaluation of long-term results for efficacy and safety determination of the technique are necessary.

Keywords:

pelvic prolapse

mesh implant

pelvic floor reconstruction

Authors:

Gvozdev M.Iu.

kafedra urologii Moskovskogo gosudarstvennogo mediko-stomatologicheskogo universiteta

Tupikina N.V.

Kafedra urologii Moskovskogo gosudarstvennogo mediko-stomatologicheskogo universiteta

Kasian G.R.

Kafedra urologii Moskovskogo gosudarstvennogo mediko-stomatologicheskogo universiteta

Pushkar' D.Iu.

kafedra urologii Moskovskogo gosudarstvennogo mediko-stomatologicheskogo universiteta

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