Preparation for surgical treatment of patients with severe forms of pelvic organ prolapse complicated by trophic disorders

Objective. Improvement of the results of preop erative preparation of women with III-IV stage genital prolapse and trophic disorders of the vaginal and cervical mucosa. Methods. A prospective, observational, non-interventional, non-comparative clinical included 51 patients with III-IV grade pelvic organ prolapse (POP) with the presence of decubital ulcers of the vaginal and cervix mucosa. The POP degree was determined according to the POP-Q classification. For complex treatment, perforated cubic Dr Arabin pessaries with individual size selection were used. Decubital ulcers were treated by irrigation with cavitated solutions, in some cases using argon plasma coagulation (once), a gel with chlorhexidine/allantoin and an estriol-containing cream. Results. The participants’ age was 34-87years, mean age 66.9±12.7 years. Complete epithelization of ulcerative defects was achieved in all cases (100%), the average healing time for ulcerous defects was 11.3±2.4 days. The frequency of replacing the size of the pessary was 23.5% within 1 month. The incidence of side effects was 1.1%. After ulcer healing, 47.1% of patients underwent surgery, the rest chose a pessary for further use. Conclusion. Comprehensive treatment using irrigation with cavitated solutions of aniseptics, pessaries, estriol and agents with an epithelizing effect is an integral part of the preoperative preparation of patients with severe prolapse and decubital ulcers, which allows achieving a fairly quick positive effect in 100% of cases and makes it possible to carry out surgical treatment in conditions of normal tissue trophism.

pelvic organ prolapse, urinary incontinence, Dr Arabin pessary, decubital ulcer, cavitated solutions