A three-year experience of a post-hysterectomy apical prolapse surgical treatment in menopausal women

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Resumo

Post-hysterectomy vaginal vault prolapse (PHVVP) remains a topical problem in pelvic floor reconstructive surgery.

Objective: To compare the effectiveness of two different surgical approaches for the treatment of PHVVP in postmenopausal women: laparoscopic lateral vaginal vault fixation with mesh implant and vaginal colpocleisis (median colporrhaphy) using autologous tissues.

Materials and methods: 61 patients with PHVVP were examined in the Department of Operative Gynecology of the Bauman City Hospital No. 29 during the period of December 2022–December 2025. In group P (n=39), laparoscopic lateral fixation of the vaginal vault with a mesh implant was performed. In group B (n=22), midline colporrhaphy was conducted using the patient's own tissues. Anatomical results were assessed using the POP-Q system. The subjective results were evaluated using the PFDI-20 and PFIQ-7 questionnaires.

Results: After finishing of the surgeries in both groups, we were continuing observations, repeated examinations of the patients and questionnaire surveys for 3 years. The overall objective effectiveness rate in Group P was 84.6% (33/39), in Group B – 90.9% (20/22). According to the results of the PFDI-20 and PFIQ-7 questionnaires, the level of subjective effectiveness of the surgery in Group P was 92.3% (36/39), in Group B – 86.3% (19/22).

Conclusion: Both laparoscopic lateral fixation of the vaginal vault with a mesh implant and median colporrhaphy in PHVVP give opportunity to achieve good anatomical results with minimal complications. However, the higher recurrence rate of apical prolapse after vaginal surgery using the patient's own tissues doubts the effectiveness of midline colporrhaphy in patients with PHVVP.

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Sobre autores

Polina Melnik

Bauman City Hospital No. 29

Autor responsável pela correspondência
Email: Pomelya97@mail.ru
ORCID ID: 0000-0002-5998-1494
Código SPIN: 4504-3978

obstetrician-gynecologist at the Gynecological Department

Rússia, 111020, Moscow, Gospitalnaya sqr., 2

Kseniya Katsura

Patrice Lumumba Peoples’ Friendship University of Russia

Email: kseniya.libra@mail.ru
ORCID ID: 0000-0002-1300-6271
Código SPIN: 3412-9301

PhD student, Department of Obstetrics, Gynecology with a course of perinatology, Medical Institute

Rússia, 117198, Moscow, Miklukho-Maklaya str.

Kseniya Posnova

Patrice Lumumba Peoples’ Friendship University of Russia

Email: slepova.kseniya@mail.ru
ORCID ID: 0009-0009-6989-5934

PhD student, Department of Obstetrics, Gynecology with a course of perinatology, Medical Institute

Rússia, 117198, Moscow, Miklukho-Maklaya str.

Milana Lologaeva

Bauman City Hospital No. 29; Patrice Lumumba Peoples’ Friendship University of Russia

Email: Milanalologaeva@gmail.com
ORCID ID: 0000-0001-7468-0924
Código SPIN: 9528-2813

PhD, Teaching Assistant, Department of Obstetrics, Gynecology with a course of perinatology, Medical Institute, obstetrician-gynecologist at the Gynecological Department

Rússia, 117198, Moscow, Miklukho-Maklaya str., 8; 111020, Moscow, Gospitalnaya sqr., 2

Dmitrii Aryutin

Bauman City Hospital No. 29; Patrice Lumumba Peoples’ Friendship University of Russia

Email: Aryutin@mail.ru
ORCID ID: 0000-0003-0258-8445
Código SPIN: 8235-5040

PhD, Associate Professor at the Department of Obstetrics, Gynecology with a course of perinatology, Medical Institute, Head of the Gynecological Department

Rússia, 117198, Moscow, Miklukho-Maklaya str., 8; 111020, Moscow, Gospitalnaya sqr., 2

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