Journal of obstetrics and women's diseasesJournal of obstetrics and women's diseases1684-04611683-9366Eco-Vector908610.17816/JOWD67355-63Research ArticleVaginal apical and anterior reconstruction using ultralight weight mesh: two-year follow-upShkarupaDmitry D.<p>MD, PhD, DSci (Medicine), Сhief Urologist, Deputy Director for Medical Care</p>shkarupa.dmitry@mail.ruKubinNikita D.<p>MD, PhD</p>nikitakubin@gmail.comPopovEduard N.<p>MD, PhD, DSci (Medicine), the Head of the Department of Operative Gynecology</p>edvardpopov@mail.ruShapovalovaEkaterina A.<p>MD, Obstetrician-Gynecologist</p>katerina_andmed@mail.ruKovalevGleb V.<p>Student</p>kovalev2207@gmail.comPisarevAlexey V.<p>MD</p>alexey.v.pisarev@gmail.comN.I. Pirogov Clinic for Advanced Medical Technologies affiliated with Saint Petersburg State UniversityResearch Institute of Obstetrics, Gynecology and Reproductology n.a. D.O. OttNorth-Western State Medical University named after I.I. Mechnikov15072018673556319072018Copyright © 2018, Shkarupa D.D., Kubin N.D., Popov E.N., Shapovalova E.A., Kovalev G.V., Pisarev A.V.2018<p><strong>Introduction</strong>. Anterior and apical prolapse is the most common type of pelvic organ prolapse. The insufficient effectiveness of native tissue repair in the pelvic organs leads to the search of new methods of the pelvic floor reconstruction.</p>
<p><strong>Objective</strong>. The current analysis was undertaken to evaluate the efficiency of the use of the Pelvix anterior mesh system (Lintex) with sacrospinous fixation of the apex in the treatment of anterior and apical prolapse.</p>
<p><strong>Methods</strong>. This study involved 150 women suffering from anterior-apical prolapse (stages III and IV). Reconstruction with the use of the mesh was performed in all the patients. To evaluate the results of surgical treatment, data of a vaginal examination (POP-Q), uroflowmetry, bladder ultrasound, and validated questionnaires (PFDI-20, PFIQ-7, PISQ-12) were used. All the listed parameters were determined before the surgery and on follow-up visits in 1, 6, 12, and 24 months after the treatment.</p>
<p><strong>Results</strong>. Mean operation time was 47 minutes. No cases of intraoperative clinically significant bleeding were reported. Anatomical cure rate ( stage II / asymptomatic stage II, according to the Baden-Walker system) at 12 months was found to be 94.4%, and at 24 months 92.7%. Within the first month of follow-up, de novo stress urinary incontinence and de novo urgency occurred in 8.0% and 7.2% of patients, respectively. Statistically significant (p 0.05) improvement in uroflowmetry parameters and decreased post-voiding urine volume were achieved after the surgery and did not change by 24 months. Comparison of the scores by the questionnaires revealed a significant improvement in the quality of life in the postoperative period.</p>
<p><strong>Conclusion</strong>. The use of the Pelvix anterior mesh system in the surgical correction of the anterior and apical prolapse is a safe uterus-sparing technique. At two-year follow-up, it provides a high anatomical efficiency, normalizes urodynamic parameters and improves quality of life.</p>pelvic organ prolapsecystocelemeshPelvix anteriorпролапс органов малого тазацистоцелесетчатый эндопротезПелвикс передний[Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, et al. The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1037-1045. doi: 10.1007/s00192-009-0902-1.][Буянова С.Н., Щукина Н.А., Зубова Е.С., и др. Пролапс гениталий // Российский вестник акушера-гинеколога. - 2017. - Т. 17. - № 1. - C. 37-45. [Buyanova SN, Shchukina NA, Zubova ES, et al. Genital prolapse. Rossiiskii Vestnik Akushera-Ginekologa. 2017;17(1):37-45. 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