ORIGINAL ARTICLE   

Minerva Ginecologica 2020 August;72(4):202-11

DOI: 10.23736/S0026-4784.20.04532-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Postoperative pelvic dysfunctions associated with the reconstruction of the pelvic floor

Viktoriya A. KRUTOVA ¹, Olga V. TARABANOVA ¹, Aminat A. KHACHETSUKOVA ¹ ✉, Aleksandr A. KHALAPHYAN ²

¹ The Clinic of the Federal State Budgetary, Educational Institution of Higher Education Kuban State Medical University, Ministry of Healthcare of the Russian Federation, Krasnodar, Russia; ² Federal State Budgetary, Educational Institution of Higher Education Kuban State University, Department of Intelligent Information Systems, Ministry of Science and Higher Education of the Russian Federation, Krasnodar, Russia

BACKGROUND: The authors were aiming to conduct the comparative analysis of the frequency of formation of pelvic dysfunctions after surgical correction of genitalia prolapse in women by a vaginal approach using native tissue repair of the vaginal paries and synthetic implants.
METHODS: The study included 546 patients with stage II-IV genitalia prolapse according to the POP-Q classification. The quality of life was assessed using PD-QL and PFIQ-7 questionnaires. The 1st group included patients after native tissue repair (N.=314), the 2^nd - after surgery with the use of synthetic implants (N.=232).
RESULTS: In the 1^st group de-novo dysfunctions were revealed as follows: stress urinary incontinence: in 4.9% of women, urgency: in 2.2%, obstructive urination: in 8.0%; constipation or fecal and flatal incontinence: none. The index of pelvic floor dysfunction decreased from 50±14% to 8±2%. The index of influence on the quality of life decreased from 81±14% to 9% after 12 months. In the 2^nd group, de-novo dysfunctions were revealed as follows: stress urinary incontinence: in 9.5% of women, urgency: in 9.1%, obstructive urination: in 23.7%; constipation or fecal and flatal incontinence: 1 patient (0.4%). In patients of the 2^nd group, there was a decrease in the pelvic floor dysfunction index from 48±12% to 10±2%. The index of influence on the quality of life decreased from 79±15% to 5% after 12 months.
CONCLUSIONS: The use of synthetic implants causes the formation of de novo pelvic dysfunctions more often than the native tissue repair.

KEY WORDS: Pelvic organ prolapse; Urinary incontinence, stress; Urinary incontinence, urge; Constipation; Fecal incontinence