open access
Comparison of life quality between geriatric patients who underwent reconstructive surgery and obliterative surgery for pelvic organ prolapse
, 1
Affiliations- Department of Obstetrics and Gynecology, Izmir Tepecik Education and Reseach Hospital, Izmir, Turkey
open access
Abstract
Objectives: Pelvic organ prolapse (POP) adversely affects women’s quality of life. The aim of this study is to compare the life quality after obliterative surgery and reconstructive surgery for geriatric patients with advanced pelvic organ prolapse.
Material and methods: This matched case control study included sexually inactive women aged 65 years or older who had vaginal surgery for pelvic organ prolapse in Tepecik Education and Research Hospiltal between August 2012 and June 2019. Life quality of women who had undergone obliterative or reconstructive vaginal surgery were evaluated and then compared by Turkish validated prolapse quality of life questionnaire (P-QOL). Patients in obliterative and recontructive surgical procedures were matched according to age, body mass index and POP stage and each group included 49 women.
Results: P-QOL scale domains, including prolapse impact (26.6 ± 12.1 vs 34.1 ± 16.2; p = 0.01), physical/social limitations (28.3 ± 12.8 vs 34.8 ± 14.4; p = 0.02) and severity measures (24.9 ± 12.6 vs 30.5 ± 13,4; p = 0.035) revealed significantly lower postoperative deterioration in the obliterative group. No significant difference was found in other P-QOL domains. The mean operation time in the obliterative group was shorter than the reconstructive group (respectively; 69.2 ± 21.5 min, 79.7 ± 29.4, p = 0.04). There were no significant differences in estimated blood loss, length of hospital stay and intraoperative complications.
Conclusions: Obliterative surgery is a suitable option in the treatment of advanced pelvic organ prolapse in elderly patients.
Abstract
Objectives: Pelvic organ prolapse (POP) adversely affects women’s quality of life. The aim of this study is to compare the life quality after obliterative surgery and reconstructive surgery for geriatric patients with advanced pelvic organ prolapse.
Material and methods: This matched case control study included sexually inactive women aged 65 years or older who had vaginal surgery for pelvic organ prolapse in Tepecik Education and Research Hospiltal between August 2012 and June 2019. Life quality of women who had undergone obliterative or reconstructive vaginal surgery were evaluated and then compared by Turkish validated prolapse quality of life questionnaire (P-QOL). Patients in obliterative and recontructive surgical procedures were matched according to age, body mass index and POP stage and each group included 49 women.
Results: P-QOL scale domains, including prolapse impact (26.6 ± 12.1 vs 34.1 ± 16.2; p = 0.01), physical/social limitations (28.3 ± 12.8 vs 34.8 ± 14.4; p = 0.02) and severity measures (24.9 ± 12.6 vs 30.5 ± 13,4; p = 0.035) revealed significantly lower postoperative deterioration in the obliterative group. No significant difference was found in other P-QOL domains. The mean operation time in the obliterative group was shorter than the reconstructive group (respectively; 69.2 ± 21.5 min, 79.7 ± 29.4, p = 0.04). There were no significant differences in estimated blood loss, length of hospital stay and intraoperative complications.
Conclusions: Obliterative surgery is a suitable option in the treatment of advanced pelvic organ prolapse in elderly patients.
Keywords
gynecologic surgery; pelvic organ prolapse; quality of life; urogenital prolapse
About this articleTitle
Comparison of life quality between geriatric patients who underwent reconstructive surgery and obliterative surgery for pelvic organ prolapse
Journal
Issue
Article type
Research paper
Pages
695-700
Published online
2021-04-14
Page views
6660
Article views/downloads
643
DOI
Pubmed
Bibliographic record
Ginekol Pol 2021;92(10):695-700.
Keywords
gynecologic surgery
pelvic organ prolapse
quality of life
urogenital prolapse
Authors
Suna Yıldırım Karaca
İbrahim Egemen Ertaş
References (18)- Wu J, Hundley A, Fulton R, et al. Forecasting the Prevalence of Pelvic Floor Disorders in U.S. Women. Obstetrics & Gynecology. 2009; 114(6): 1278–1283.
- Hendrix SL, Clark A, Nygaard I, et al. Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 2002; 186(6): 1160–1166.
- Jelovsek J, Maher C, Barber M. Pelvic organ prolapse. The Lancet. 2007; 369(9566): 1027–1038.
- Schweitzer KJ, Vierhout ME, Milani AL. Surgery for pelvic organ prolapse in women of 80 years of age and older. Acta Obstet Gynecol Scand. 2005; 84(3): 286–289.
- Petcharopas A, Wongtra-Ngan S, Chinthakanan O. Quality of life following vaginal reconstructive versus obliterative surgery for treating advanced pelvic organ prolapse. Int Urogynecol J. 2018; 29(8): 1141–1146.
- Barber MD, Amundsen CL, Paraiso MFR, et al. Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18(7): 799–806.
- Murphy M, Sternschuss G, Haff R, et al. Quality of life and surgical satisfaction after vaginal reconstructive vs obliterative surgery for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol. 2008; 198(5): 573.e1–573.e7.
- Cam C, Sakalli M, Ay P, et al. Validation of the prolapse quality of life questionnaire (P-QOL) in a Turkish population. Eur J Obstet Gynecol Reprod Biol. 2007; 135(1): 132–135.
- Zebede S, Smith AL, Plowright LN, et al. Obliterative LeFort colpocleisis in a large group of elderly women. Obstet Gynecol. 2013; 121(2 Pt 1): 279–284.
- Petri E, Ashok K. Sacrospinous vaginal fixation--current status. Acta Obstet Gynecol Scand. 2011; 90(5): 429–436.
- Maher C, Baessler K, Glazener CMA, et al. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2004(4): CD004014.
- Aigmueller Th, Riss P, Dungl A, et al. Long-term follow-up after vaginal sacrospinous fixation: patient satisfaction, anatomical results and quality of life. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19(7): 965–969.
- Murphy M, Sternschuss G, Haff R, et al. Quality of life and surgical satisfaction after vaginal reconstructive vs obliterative surgery for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol. 2008; 198(5): 573.e1–573.e7.
- Hagen S, Stark D. Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2011(12): CD003882.
- Petcharopas A, Wongtra-Ngan S, Chinthakanan O. Quality of life following vaginal reconstructive versus obliterative surgery for treating advanced pelvic organ prolapse. Int Urogynecol J. 2018; 29(8): 1141–1146.
- Bazi T. The underutilization of obliterative and constrictive surgery in the surgical treatment of pelvic organ prolapse. Int Urogynecol J. 2019; 30(8): 1221–1224.
- Takase-Sanchez MM, Brooks HM, Hale DS, et al. Obliterative Surgery for the Treatment of Pelvic Organ Prolapse: A Patient Survey on Reasons for Surgery Selection and Postoperative Decision Regret and Satisfaction. Female Pelvic Med Reconstr Surg. 2015; 21(6): 325–331.
- Ghezzi F, Uccella S, Cromi A, et al. Surgical treatment for pelvic floor disorders in women 75 years or older: a single-center experience. Menopause. 2011; 18(3): 314–318.
