Menopause Review (Feb 2011)
Odległe powikłania i częstości reoperacji po zabiegach rekonstrukcji dna miednicy z użyciem materialów syntetycznych
Abstract
Objectives: Although the efficacy of Prolift® System exceeds 90%, prolapse recurrence and other late postsurgicalcomplications may occur. The aim of the study was to assess the reoperation rate in a group of patientswho underwent Prolift® System procedure due to advanced pelvic organ prolapse. Material and methods: One hundred and eighteen patients who underwent reconstructive surgery withProlift® System due to pelvic organ prolapse were included in the study. Follow-up visits took place 6 weeksand between 3 and 6 as well as 12 months after the primary surgery. Results: Twenty eight patients (23.7%)required an additional operation due to late post-surgical complications: 8 (6.8%) with de novo SUI, 4 (3.4%)with recurrence of SUI, 10 (8.5%) with recurrence of prolapse, 1 (0.8%) with granuloma and 6 (5.1%) with mesherosions. In 8 patients who developed SUI and in 4 with recurrence of SUI, the IVS 04M surgery was performed.Cervix amputation including posterior colporrhaphy was performed in 9 patients with prolapse recurrence andin one woman sacrocolpopexy was done. In the case of mesh erosion and granuloma formation, partial removal of prosthesis and granuloma tissue was done. Analysis of cases with prolapse recurrence revealed that decreaseof urogenital hiatus by additional posterior colporrhaphy can reduce cervix prolapse. Conclusions: Surgery treatment of genital prolapse with synthetic prostheses interposed by the vaginalroute is effective and characterized by a low rate of late post-surgical complications. However, our study showsa certain number of such complications and the majority of them were de novo SUI and apical prolapse recurrence.Concomitant sling SUI treatment with POP correction is not less effective than midurethral sling alone. Morecareful diagnosis of possible occult SUI before treatment and concomitant anti-incontinence procedure mayreduce the incidence of postoperative urinary incontinence.
