Lesser invasive technologies in correction of stress uroclepsia in pelvic prolapse

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Conclusion. The optimal way for treatment of patients with pelvic prolapse complicated by cysto- and rectocele is combined operation which makes it possible to carry out correction of genital prolapse (including remodeling of pelvic floor) and to eliminate functional disorders of annexa. At that the best functional results are reached by means of loop urethronexy (TVT and TVT-O) and sacrovaginoplasty (LS-MESH). In addition, it is necessary to note that single-step prolapse correction, incontinence and disorders of defecation act using lesser invasive technologies, significantly decrease operational trauma, improve the results of surgical treatment, have high medical, social, economic effect and improve the quality of patient’s life.

The purpose: improvement of results of stress uroclepsia treatment in women with pelvic prolapse using free synthetical loops from prolen (TVT, TVT-O).

The material and methods. The analysis of treatment of 132 women with pelvic prolapse and uroclepsia. All women were operated for prolapse and correction of incontinence. Control group consisted of 53 women operated before who also suffered from prolapse and incontinence but surgical treatment was carried out only in respect of prolaspe. Then these patients were operated in urological hospitals where the operation of Kraats in modification using short autodermal flap was carried out. The operations in patients of main group were performed in two stages. At first stage the correction of uroclepsia was carried out. At second stage elimination of prolapse was carried out. For correction of uroclepsia free synthetical loops TVT (in 112 cases) and TVT-O (in 20 cases) were used. The indications for usage of TVT and TVT-O were uroclepsia predominantly in strain of second type according to Mc. Guire in combination with pelvic prolapse. Intubation narcosis was used in all cases.

Results. Immediate and long-term results of operations were studied. The fates of surgical treatment were estimated as positive and negative. Positive results are the results when patients after operation can keep urine; negative results are the results when the operation did not affect and the patients had to use cappings. During 2-5 days of postoperative period positive results in main group were achieved in all 132 (100%) of patients. In these women natural urination was restored, uroclepsia symptoms disappeared. Ultrasonography was carried out in regard of all patients with the purpose of postoperative control; it discovered decrease of urethra size, absence of residual urine and basis of urocyst was situated higher; its pathologic instability disappeared - it is the result of prolapse correction.

The analysis of long-term results of operations comparatively in patients of main and control group showed that in patients of second group (according to data of retrospective) negative results were observed in 2 (3,7,%) patients in 3 months, in 3 patients (5,7%) in 6 months, in 6 (11,3%) in 12 months and in more than year - in 3 (5,7%). Total number of backsets in patients of control group amounted to 14 (26,4%). As a result, operation with usage of free synthetical loops (TVT and TVTO) was effective in all 100% women who suffered from genital prolapse in combination with stress uroclepsia.

Results. Besides, the best results are achieved in accurate selection of patients and observance of surgical interference technique.

作者简介

A. Korkan

Post-qualifying obstetritian-gynaecologist education Institution

编辑信件的主要联系方式.
Email: info@eco-vector.com
哈萨克斯坦, Nur-Sultan (Astana), Kazakhstan

А. Korabelnikov

Post-qualifying obstetritian-gynaecologist education Institution

Email: info@eco-vector.com
哈萨克斯坦, Nur-Sultan (Astana), Kazakhstan

I. Korkan

Post-qualifying obstetritian-gynaecologist education Institution

Email: info@eco-vector.com
哈萨克斯坦, Nur-Sultan (Astana), Kazakhstan

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