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Research paper
Published online: 2021-08-06
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Preperitoneal laparoscopic lateral repair in pelvic organ prolapse — a novel approach

Pawel Szymanowski1, Wioletta K. Szepieniec1, Hanna Szweda1
DOI: 10.5603/GP.a2021.0120
·
Pubmed: 34541640
Affiliations
  1. Andrzej Frycz Modrzewski Krakow University, Faculty of Medicine and Health Sciences, Cracow, Poland, Poland

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2021-08-06

Abstract

Objectives: The aim of this study is to present a novel approach for a paravaginal defect treatment. This extraperitoneal
approach can be performed in patients with comorbidities and on obese patients. The main advantages are: not requiring
the pneumoperitoneum and the Trendelenburg position and the avoidance of peritoneal adhesions.
Material and methods: This study presents the results in 27 patients with cystocele caused by a lateral defect pelvic organ
prolapse quantification (POP Q) stage II or higher. The procedure was performed with a modified Richardson and Burch
technique using a preperitoneal approach. Three follow-up examinations were conducted two, six weeks, and six months
after the operation. A quality of life assessment was conducted before and after surgery using the short form of the PFIQ‐7.
Results: All patients had a POP Q II cystocele and 59% had concomitant stress urinary incontinence. In all patients cystocele
was reduce to asymptomatic POP Q stage I or 0. Mean operation time was approximately 80 minutes. In six months
post-operation follow up, one case of recurrence was noted. The patients’ quality of life revealed a statistical improvement
from an average of 6.8 points before, to an average of 0.7 points after the operation (p < 0.05) in the PFIQ-7.
Conclusions: Preperitoneal laparoscopic lateral repair is a relatively fast procedure and it is also feasible for obese women
and for patients with a cardiopulmonary risk. Neither the Trendelenburg position nor the pneumoperitoneum are required.
Postoperatively, the patients witnessed a reduction of the cystocele and complaints connected with their previous condition.

Abstract

Objectives: The aim of this study is to present a novel approach for a paravaginal defect treatment. This extraperitoneal
approach can be performed in patients with comorbidities and on obese patients. The main advantages are: not requiring
the pneumoperitoneum and the Trendelenburg position and the avoidance of peritoneal adhesions.
Material and methods: This study presents the results in 27 patients with cystocele caused by a lateral defect pelvic organ
prolapse quantification (POP Q) stage II or higher. The procedure was performed with a modified Richardson and Burch
technique using a preperitoneal approach. Three follow-up examinations were conducted two, six weeks, and six months
after the operation. A quality of life assessment was conducted before and after surgery using the short form of the PFIQ‐7.
Results: All patients had a POP Q II cystocele and 59% had concomitant stress urinary incontinence. In all patients cystocele
was reduce to asymptomatic POP Q stage I or 0. Mean operation time was approximately 80 minutes. In six months
post-operation follow up, one case of recurrence was noted. The patients’ quality of life revealed a statistical improvement
from an average of 6.8 points before, to an average of 0.7 points after the operation (p < 0.05) in the PFIQ-7.
Conclusions: Preperitoneal laparoscopic lateral repair is a relatively fast procedure and it is also feasible for obese women
and for patients with a cardiopulmonary risk. Neither the Trendelenburg position nor the pneumoperitoneum are required.
Postoperatively, the patients witnessed a reduction of the cystocele and complaints connected with their previous condition.

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Keywords

lateral defect; Richardson operation; paravaginal repair; Burch operation; preperitoneal approach Ginekologia Polska

About this article
Title

Preperitoneal laparoscopic lateral repair in pelvic organ prolapse — a novel approach

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-08-06

DOI

10.5603/GP.a2021.0120

Pubmed

34541640

Keywords

lateral defect
Richardson operation
paravaginal repair
Burch operation
preperitoneal approach Ginekologia Polska

Authors

Pawel Szymanowski
Wioletta K. Szepieniec
Hanna Szweda

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