COMPLICATIONS FROM PELVIC ORGAN PROLAPSE CORRECTION USING A PROLIFT PROLENE SYSTEM: WAYS OF PREVENTION AND QUALITY OF LIFE


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Objective. To study the frequency and pattern of intra- and postoperative complications during pelvic repair using a Prolift prolene system in women with internal genital prolapse (IGP), to develop methods for preventing these complications and to estimate quality of life in patients operated on. Subjects and methods. The D.O. Ott Research Institute of Obstetrics and Gynecology, Northwestern Branch, Russian Academy of Medical Sciences, examined and treated 300 patients with POP-Q classification (ICS, 1996) Stages II—IV pelvic organ prolapse. The basic volume of surgery consisted in retroperitoneal vaginal colpopexia using the Prolift system. In the late postoperative period, follow-ups were carried out at 1, 6, and 12 months and then once a year. The postoperative management protocol of 40 patients operated on during 2010—2011 involved the local prophylactic use of the ascorbic acid preparation Vaginorm-C in order to correct/prevent bacterial vaginosis and to create optimal conditions for implant attachment and vaginal wound epithelization. Results. During 12—20-month postoperative follow-ups, no vaginal mucosal erosions were noted in the patients receiving Vaginorm-C in the postoperative period, then topical lactoflora agent (acylact). Following 12-month follow-up, the quality of life in these patients turned out to be significantly higher than that in the patients who did not receive Vaginorm-C or lactoflora agents. Conclusion. The use of the Prolift prolene system for the surgical treatment of IGP may cause a number of intra-and postoperative complications. The administration of the agents for the pre- and postoperative correction of bacterial vaginosis along with a package of preventive measures permits the rate of vaginal mucosal erosions to be substantially reduced. The authors have developed a package of measures to prevent and eliminate infectious complications, including those using Vaginorm-С for the correction of vaginal dysbiosis, and a postoperative management protocol for patients with vaginopexia along with the Prolift system, which comprises of a few stages (a patient management algorithm on postoperative days 2—10, 10—20, and 20—40).

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Sobre autores

V. BEZHENAR

D.O. Ott Research Institute of Obstetrics and Gynecology, Northwestern Branch, Russian Academy of Medical Science

E. BOGATYREVA

V.A. Almazov Federal Heart, Blood, and Endocrinology Center, Ministry of Health and Social Development of Russia

A. TSYPURDEYEVA

D.O. Ott Research Institute of Obstetrics and Gynecology, Northwestern Branch, Russian Academy of Medical Science

L. TSULADZE

D.O. Ott Research Institute of Obstetrics and Gynecology, Northwestern Branch, Russian Academy of Medical Science

E. RUSINA

D.O. Ott Research Institute of Obstetrics and Gynecology, Northwestern Branch, Russian Academy of Medical Science

E. GUSEVA

D.O. Ott Research Institute of Obstetrics and Gynecology, Northwestern Branch, Russian Academy of Medical Science

Email: iag@mail.ru

Bibliografia

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