Efficiency of laparoscopic ventrofixation of the uterus with colpopexy and perineoplasty in elderly and senile patients

The authors provide rationale for laparoscopic ventrofixation of the uterus with colpopexy as a method for correction of internal genital descent and prolapse in elderly and senile patients. Sixty-four women over 60 years of age were operated on for internal genital descent and prolapse. Group 1 patients (n=31) underwent vaginal hysterectomy after the Mayo procedure with the McCall culdoplasty; Group 2 patients (n=33) had laparoscopic ventrofixation of the uterus with colpopexy. Perineolevatoroplasty was an ultimate and obligatory surgical stage in all the patients. Group 1 and 2 patients were matched for age, the pattern of extragenital pathology, and the degree of genital prolapse. The study comprised physical examination, transvaginal ultrasonography of small pelvic organs, urological functional tests (a loading or cough stress test, Marchetti test), residual urine volume measurement, bacteriological test of the middle portion of the urine, and Kubicek's tetrapolar rheography. Combination therapy involving endoscopic fixation of the vaginal vault and corpus uteri and perineolevatoroplasty allows the achievement of a steady-state effect due to the concurrent elimination of several defects of the uterine fixation apparatus.

internal genital descent and prolapse, ventrofixation, colpopexy, perineolevatoroplasty, laparoscopy, central hemodynamics