open access

Vol 92, No 7 (2021)
Research paper
Published online: 2021-03-30
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Anterior abdominal fixation — a new option in the surgical treatment of pelvic organ prolapse

Jakub Sliwa1, Anna Kryza-Ottou1, Justyna Grobelak1, Zygmunt Domagala1, Mariusz Zimmer1
DOI: 10.5603/GP.a2021.0004
·
Pubmed: 33844247
·
Ginekol Pol 2021;92(7):471-474.
Affiliations
  1. Departament of Obstetrics and Gynecology, Medical University of Wroclaw, Poland

open access

Vol 92, No 7 (2021)
ORIGINAL PAPERS Gynecology
Published online: 2021-03-30

Abstract

Objectives: To present anterior abdominal fixation — a new surgical technique for the treatment of pelvic organ prolaps (POP) and to evaluate the results of the treatment of patients with stage III and IV POP operated using this technique.
Material and methods: Anterior abdominal fixation for treating stage III and IV POP was carried out in 42 women, who were qualified according to the Pelvic Organ Prolapse Quantification System (POP-Q) scale at baseline and after 12 months. The Pelvic Floor Disability Index-20 (PFDI-20), along with its symptom scales, were evaluated.
Results: The mean age 42 operated women was 64.5 years, and the average BMI was 27.3 (83% women were overweight). At baseline, 29 (69%) women had POP stage IV, and 13 (31%) women had POP stage III. Overall, 14 (33%) underwent laparoscopy, 28 (67%) underwent laparotomy. At 12 months, 14 (33.3%) women had POP stage I; 21 (50%) women had POP stage II. Seven patients (16.6%) experienced a recurrence of disease with advancement at the degree of III/IV; 4 (9.5%) women required adjuvant surgery in the form of anterior and posterior vaginal wall surgery. No early complications after surgery were observed. The comparison of the results before and after surgery showed statistically significant improvement in terms of the P-QoL score as well as PFDI-20 along with its 3 symptom scales.
Conclusions: Anterior abdominal fixation of the uterus to the anterior abdominal wall is effective, safe, and technically easy to perform in the treatment of POP of advanced stage.

Abstract

Objectives: To present anterior abdominal fixation — a new surgical technique for the treatment of pelvic organ prolaps (POP) and to evaluate the results of the treatment of patients with stage III and IV POP operated using this technique.
Material and methods: Anterior abdominal fixation for treating stage III and IV POP was carried out in 42 women, who were qualified according to the Pelvic Organ Prolapse Quantification System (POP-Q) scale at baseline and after 12 months. The Pelvic Floor Disability Index-20 (PFDI-20), along with its symptom scales, were evaluated.
Results: The mean age 42 operated women was 64.5 years, and the average BMI was 27.3 (83% women were overweight). At baseline, 29 (69%) women had POP stage IV, and 13 (31%) women had POP stage III. Overall, 14 (33%) underwent laparoscopy, 28 (67%) underwent laparotomy. At 12 months, 14 (33.3%) women had POP stage I; 21 (50%) women had POP stage II. Seven patients (16.6%) experienced a recurrence of disease with advancement at the degree of III/IV; 4 (9.5%) women required adjuvant surgery in the form of anterior and posterior vaginal wall surgery. No early complications after surgery were observed. The comparison of the results before and after surgery showed statistically significant improvement in terms of the P-QoL score as well as PFDI-20 along with its 3 symptom scales.
Conclusions: Anterior abdominal fixation of the uterus to the anterior abdominal wall is effective, safe, and technically easy to perform in the treatment of POP of advanced stage.

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Keywords

pelvic organ prolapse; quality of life; women’s health

About this article
Title

Anterior abdominal fixation — a new option in the surgical treatment of pelvic organ prolapse

Journal

Ginekologia Polska

Issue

Vol 92, No 7 (2021)

Article type

Research paper

Pages

471-474

Published online

2021-03-30

DOI

10.5603/GP.a2021.0004

Pubmed

33844247

Bibliographic record

Ginekol Pol 2021;92(7):471-474.

Keywords

pelvic organ prolapse
quality of life
women’s health

Authors

Jakub Sliwa
Anna Kryza-Ottou
Justyna Grobelak
Zygmunt Domagala
Mariusz Zimmer

References (9)
  1. Haylen BT, Maher CF, Barber MD, et al. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J. 2016; 27(2): 165–194.
  2. Chow D, Rodríguez LV. Epidemiology and prevalence of pelvic organ prolapse. Curr Opin Urol. 2013; 23(4): 293–298.
  3. Śliwa J, Rosner-Tenerowicz A, Kryza-Ottou A, et al. Analysis of prevalence of selected anamnestic factors among women with pelvic organ prolapse. Adv Clin Exp Med. 2018; 27(2): 179–184.
  4. Manonai J, Mouritsen L, Palma P, et al. The inter-system association between the simplified pelvic organ prolapse quantification system (S-POP) and the standard pelvic organ prolapse quantification system (POPQ) in describing pelvic organ prolapse. Int Urogynecol J. 2011; 22(3): 347–352.
  5. Park AJ, Paraiso MFR. Surgical management of uterine prolapse. Minerva Ginecol. 2008; 60(6): 493–507.
  6. Kale A, Biler A, Terzi H, et al. Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery. Int Braz J Urol. 2017; 43(5): 903–909.
  7. Husby KR, Lose G, Klarskov N. Trends in apical prolapse surgery between 2010 and 2016 in Denmark. Int Urogynecol J. 2020; 31(2): 321–327.
  8. Anglim B, O'Sullivan O, O'Reilly B. How do patients and surgeons decide on uterine preservation or hysterectomy in apical prolapse? Int Urogynecol J. 2018; 29(8): 1075–1079.
  9. Śliwa J, Kryza-Ottou A, Zimmer-Stelmach A, et al. A new technique of laparoscopic fixation of the uterus to the anterior abdominal wall with the use of overfascial mesh in the treatment of pelvic organ prolapse. Int Urogynecol J. 2020; 31(10): 2165–2167.

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