Surgery for pelvic organ prolapse by vaginal approach in a specialized center: the evolution of implants from «XL to XS»

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Abstract

Aim. To find the most safe and effective method of surgical treatment of POP.

Materials and methods. To evaluate the efficiency of surgical techniques, a retrospective study of 5031 medical records from an electronic database was carried out. As the primary endpoint, we assessed the duration of the procedure, the volume of blood loss and the length of stay. As a secondary endpoint, the number of intra- and postoperative complications was assessed. In addition to objective data, we assessed subjective measures using the validated PFDI20 and PISQ12 questionnaires.

Results. The best results in terms of blood loss were shown by unilateral hybrid pelvic floor reconstruction and three-level hybrid reconstruction (33±15 ml and 36±17 ml, respectively). Patients who underwent the three-level hybrid pelvic floor reconstruction technique had the highest result: 33±15 points of the PISQ12 questionnaire, 50±28 points of the PFDI20 questionnaire, which was significant in comparison with other techniques (p<0.001). The number of postoperative complications was also significantly lower for this procedure.

Conclusion. Three-level hybrid pelvic floor reconstruction is a safe and effective technique for the treatment of pelvic organ prolapse. In addition, this procedure can be done in a specialized hospital with the appropriate skills of surgeons.

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About the authors

D. D. Shkarupa

FGBOU VO Saint Petersburg State University

Author for correspondence.
Email: shkarupa.dmitry@mail.ru
ORCID iD: 0000-0003-0489-3451

MD, Ph.D., professor at the Department of Hospital Surgery, urologist, Director of Clinic

Russian Federation, Saint Petersburg

N. D. Kubin

FGBOU VO Saint Petersburg State University

Email: nikitakubin@gmail.com
ORCID iD: 0000-0001-5189-4639

MD, Ph.D., professor at the Department of Hospital Surgery, urologist at the Department of Urology

Russian Federation, Saint Petersburg

A. S. Shulgin

FGBOU VO Saint Petersburg State University

Email: shulginandrey74@mail.ru
ORCID iD: 0000-0002-8655-7234

Ph.D., associate professor at the Department of Hospital Surgery, Deputy Director on Medical Care, Chief, urologist of Clinic for Pirogov High Medical Technologies

Russian Federation, Saint Petersburg

I. A. Labetov

FGBOU VO Saint Petersburg State University

Email: ivanlabetov@gmail.com
ORCID iD: 0000-0001-9813-7483

urologist at the Department of Urology of Clinic for Pirogov High Medical Technologies

Russian Federation, Saint Petersburg

G. V. Kovalev

FGBOU VO Saint Petersburg State University

Email: kovalev2207@gmail.com
ORCID iD: 0000-0003-4884-6884

Ph.D., associate professor at the Department of Hospital Surgery, urologist at the Department of Urology of Clinic for Pirogov High Medical Technologies

Russian Federation, Saint Petersburg

R. A. Shakhaliev

FGBOU VO Saint Petersburg State University

Email: rustam.shahaliev@yandex.ru
ORCID iD: 0000-0003-2450-7044

gynecologist at the Department of Urology of Clinic for Pirogov High Medical Technologies

Russian Federation, Saint Petersburg

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Supplementary files

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2. Table 2. Characteristics of methods of surgical treatment of pelvic organ prolapse

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3. Drawing. Indicators of primary endpoints of the study

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