OBJECTIVE: To investigate the short term results of infracoccygeal sacropexy for the management of uterine prolpase or stump prolapse. METHODS: Thirty-four Women who underwent infracoccygeal sacropexy for the management of uterine prolapse or stump prolpase were enrolled this study. Intraoperative or postoperative complications and results of the operation were evaluated and the recurrence rate of pelvic organ prolapse was checked 6 months after operation. RESULTS: Changes of hemoglobin after infracoccygeal sacropexy was 1.7+/-0.9, mean duration of bladder drainage was 3.1+/-1.0 (days). After 2.1 days of operation, foley catheter was removed. Mean inpatient day was 5.2+/-1.0, patient discharged 3.2 days after operation. Recurrence rate after 6 months was 2.9%. Preoperative mean stage of prolapse was 2.7+/-0.7 (stage) and it decreased to 0.4+/-0.6 (stage) 6 months after operation. CONCLUSIONS: Infracoccygeal sacropexy was effective method for the management of uterine/ stump prolapse.
Catheters ; Drainage ; Female ; Humans ; Inpatients ; Pelvic Organ Prolapse ; Postoperative Complications ; Prolapse* ; Recurrence ; Urinary Bladder ; Uterine Prolapse ; Uterus*

This study aimed to investigate the relationship between bladder trabeculation, urinary function, and the stage of pelvic organ prolapse (POP). The medical records of 104 patients with POP who underwent cystoscopies and urodynamic studies were reviewed retrospectively. Age, incidence of detrusor instability, stage and site of POP, and the parameters of urodynamic studies of patients with and without bladder trabeculation were compared. The difference in the incidence of bladder trabeculation was estimated between patients with and without a suspected bladder outlet obstruction. There were significant differences in the patients' age, stage of POP, and maximal voiding velocity. Patients with a suspected bladder outlet obstruction had a significantly higher incidence of bladder trabeculation. In addition, patients with advanced stages of POP were also found to have a higher incidence of bladder trabeculation.
Uterine Prolapse/complications ; Urodynamics/*physiology ; Urinary Bladder Neck Obstruction/complications ; Urinary Bladder Diseases/*physiopathology ; Retrospective Studies ; Rectal Prolapse/complications ; Prolapse ; Pelvic Floor/physiopathology ; Middle Aged ; Humans ; Female ; Aged

Spontaneous rupture of the rectosigmoid colon and herniation of the small intestine through the rupture site and eventual evisceration through the anus is a very rare event. In the literature, only 42 cases have been reported. The majority of them occurred in patients with rectal prolapse and one case was reported in association with a third-degree uterine prolapse. We experienced an 81-year-old female patient with rectal prolapse and second-degree uterine prolapse complicated by spontaneous perforation of the rectosigmoid colon and anal evisceration of the small intestine. Segmental resection of the nonviable small intestine, primary repair of the ruptured rectosigmoid colon, and sigmoid loop colostomy were performed, and the patient recovered well. In our patient, both rectal and uterine prolapses cooperatively damaged the anterior wall of the rectosigmoid colon and resulted in perforation. So, rectal and uterine prolapses should be treated before the complication develops. In this patient, uterine prolapse should be treated because of the recurrence of this rare episode.
Aged ; Aged, 80 and over ; Case Report ; Colonic Diseases/etiology* ; Female ; Human ; Rectal Prolapse/complications* ; Rupture, Spontaneous ; Uterine Prolapse/complications*

OBJECTIVE: To determine the success rate and complications of transvaginal sacrospinous colpopexy for symptomatic uterine/vault prolapse when performed by one surgeon. METHODS: Between march 1996 and march 2002, 105 women with a symptomatic uterine/vault prolapse were treated with transvaginal sacrospinous ligament colpopexy at samsung cheil hospital. Primary outcome measures were complications (acute and long term) and success rate, with failure defined as any degree of uterine/vault prolapse requiring repeat operation, any degree of symptomatic isolated uterine/vault prolapse, any pelvic organ prolapse at or beyond the introitus. Statistical analysis was performed using simple descriptive technique. RESULTS: During the study period, 105 transvaginal sacrospinous ligament colpopexy were performed: 41 with vaginal hysterectomy, 38 without hysterectomy, 25 for post-hysterectomy vault prolapse and 1 cervical amputation. The mean duration of follow-up was 17.7 months (0-66) There were no acute hemorrhage and no deaths. There were four intraoperative complications - three rectal wall injury and one bladder wall injury. There was a complaints of postoperative right buttock pain in 8 of the 105 procedure (7.6%), with this persisting on a chronic basis in 2 patients (1.9%). Postoperatively, there were 11 patients with uterine/valut prolapse, 4 with a cystocele and 1 with a rectocele. Of these 105, there were 6 failures (5.7%). CONCLUSION: Transvaginal sacrospinous colpopexy for the correction of uterine/vault prolapse, when performed by a surgeon experienced in the procedure, is safe and effective surgical procedure and rare major complications.
Amputation ; Buttocks ; Cystocele ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Intraoperative Complications ; Ligaments ; Outcome Assessment (Health Care) ; Pelvic Organ Prolapse ; Prolapse ; Rectocele ; Urinary Bladder ; Uterine Prolapse

PURPOSE: This study aimed to investigate the surgical outcomes and safety of robotic sacrocolpopexy (RSC) in patients with uterine/vaginal vault prolapse. METHODS: Between January 2009 and June 2015, 16 women with apical prolapse underwent RSC. Pelvic organ prolapse quantification (POP-Q) examination was performed, and treatment success was defined as the presence of grade 0 or I apical prolapse upon POP-Q examination at the final follow-up. Pelvic floor distress inventory-short form 20 (PFDI-SF 20) was administered at every follow-up. A treatment satisfaction questionnaire was administered by telephone to evaluate patient satisfaction with the operation. RESULTS: Median age was 65 years (interquartile range [IQR], 56–68 years), and follow-up duration was 25.3 months (IQR, 5.4–34.0 months). Thirteen women (81.3%) had ≥grade III apical prolapse. Operation time was 251 minutes (IQR, 236–288 minutes), and blood loss was 75 mL (IQR, 50–150 mL). Median hospital stay was 4 days (IQR, 3–5 days). At the final follow-up, treatment success was reported in all patients, who presented grade 0 (n=8, 57.1%) and grade I (n=6, 42.9%) apical prolapse. Dramatic improvements in PFDI-SF 20 scores were noted after RSC (from 39 to 4; P=0.001). Most patients (12 of 13) were satisfied with RSC. An intraoperative complication (sacral venous plexus injury) was reported in 1 patient, and there was no conversion to open surgery. Mesh erosion was not reported. CONCLUSIONS: RSC is an efficient and safe surgical option for apical prolapse repair. Most patients were satisfied with RSC. Thus, RSC might be one of the best treatment options for apical prolapse in women.
Conversion to Open Surgery ; Female ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Length of Stay ; Patient Satisfaction ; Pelvic Floor ; Pelvic Organ Prolapse* ; Prolapse ; Robotic Surgical Procedures ; Telephone ; Uterine Prolapse

OBJECTIVES: We sought to describe the perioperative and postoperative adverse events associated with sacral colpopexy and evaluate the surgical outcome, complications, and benefits of laparoscopic sacral fixation for patients with pelvic prolapse. METHODS: Ninety-two women with uterine prolapse underwent sacral colpopexy between January 2011 and September 2016 at Chosun University Hospital. Patients' electronic medical records were investigated for demographic, intraoperative, and postoperative data. Strict definitions were used for all clinically relevant adverse events. Patients' outcomes were documented with 1 self-administered quality of life questionnaires: the Pelvic Floor Distress Inventory-20 focused on symptom distress. The primary analysis looking at perioperative and postoperative adverse events was descriptive and statistics were reported for all groups as n/N (%) with 95% confidence intervals for categorical variables and as mean ± standard deviation and mean (range) for all continuous variables. RESULTS: Their mean age was 69 ± 8.1 years, mean follow-up duration was 12 months, and mean operating time was 61 minutes. There were seven conversions due to anesthetic or surgical difficulties. Follow-up was performed using a telephone questionnaire and physical examination at 12 months. There were three cases of sacral pain with strong analgesics, one of vaginal erosion, two of transient urinary retentions, one of spondylitis, and two of mesh infection. Of the patients, 98.9% were satisfied with the surgical results, while none complained of sexual dysfunction or problems performing her usual activities. CONCLUSIONS: Laparoscopic sacral colpopexy is a feasible and highly effective technique that offers good long-term results with complication rates similar to those of open surgery with the added benefit of being minimally invasive.
Analgesics ; Electronic Health Records ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; Pelvic Floor ; Physical Examination ; Postoperative Complications ; Prolapse ; Quality of Life ; Spondylitis ; Telephone ; Uterine Prolapse*

OBJECTIVE: Cystocele is caused by generalized relaxation or attenuation of the endopelvic fascia. The most common etiology is birth injury. The patient with cystocele usually complains stress incontinence, bearing down sensation, difficult urination, uterine prolapse. Anterior repair is the gold standard for cystocele repair, the recurrence rate is varied from 2 to 22% at a mean follow-up of 2 and 20 years. Paravaginal repair is more effective method in the patient with cystocele combined with lateral defects. The purpose of this study was to determine effects of paravaginal repair for the patients with symptomatic cystocele and paravaginal defect METHODS: We performed laparoscopic paravaginal repair to the 9 patients with cystocele (Grade II, III). Coincidental operations were Burch colposuspension (5), uterosacral ligament plication (2), anterior colporrhaphy (2), posterior colporrhaphy (9). RESULTS: Mean operation time of paravaginal repair was 58 minutes. Blood (PRC) transfused to only one patients. Postoperative outcome was excellent. There was no postoperative complication and recurrence after a follow up of 5-25 months. CONCLUSION: We think that laparoscopic paravaginal repair is highly effective method for the correction of cystocele with lateral defect.
Birth Injuries ; Cystocele* ; Fascia ; Follow-Up Studies ; Humans ; Ligaments ; Postoperative Complications ; Recurrence ; Relaxation ; Sensation ; Urination ; Uterine Prolapse

OBJECTIVE: Cystocele is caused by generalized relaxation or attenuation of the endopelvic fascia. The most common etiology is birth injury. The patient with cystocele usually complains stress incontinence, bearing down sensation, difficult urination, uterine prolapse. Anterior repair is the gold standard for cystocele repair, the recurrence rate is varied from 2 to 22% at a mean follow-up of 2 and 20 years. Paravaginal repair is more effective method in the patient with cystocele combined with lateral defects. The purpose of this study was to determine effects of paravaginal repair for the patients with symptomatic cystocele and paravaginal defect METHODS: We performed laparoscopic paravaginal repair to the 9 patients with cystocele (Grade II, III). Coincidental operations were Burch colposuspension (5), uterosacral ligament plication (2), anterior colporrhaphy (2), posterior colporrhaphy (9). RESULTS: Mean operation time of paravaginal repair was 58 minutes. Blood (PRC) transfused to only one patients. Postoperative outcome was excellent. There was no postoperative complication and recurrence after a follow up of 5-25 months. CONCLUSION: We think that laparoscopic paravaginal repair is highly effective method for the correction of cystocele with lateral defect.
Birth Injuries ; Cystocele* ; Fascia ; Follow-Up Studies ; Humans ; Ligaments ; Postoperative Complications ; Recurrence ; Relaxation ; Sensation ; Urination ; Uterine Prolapse

A group of 30 patients with stress urinary incontinence who had been admitted to the Taegu Fatima Hospital during 5 years period from November, 1951 to October, 1956 were subjected for the clinical evaluation in respect of particular attention to surgical management. The results are as follows: 1. Patients varied in age from 34 to 65 years. All patients were multiparous with an average of 4.6 previous deliveries. 2. Clinical symptom classification (Grade I-Grade IV) of stress urinary incontinence reported by Ball was used. There were symptom distributions of Grade II in 13 patients, Grade 1 in 10, Grade III in 5 and Grade IV in 2. 3. According to Green`s classification, patients with stress urinary incontinence were classified into two basic type of urethrovesical anatomy on the cystourethrogram with respect to type 1 and type II. There were anatomic distributions of type 1 in 7 patients and type II in 8, while 15 had cystocele plus uterine prolapse. 4. With minimum follow up of 3 months, overall success rate was 93% in the surgical management (28 out of 30 patients). Success rates according to the each surgical procedure were 91% in the Pereyra procedure (10 out of 11), 83% in Afterior colporrhaphy (5 out of 6) and 100% in Anterior-Posterior colporrhaphy (10), MMK operation (2) and Stamey procedure (1). 5. Postoperative complications were minimal and infrequent except for urinary retention in 17 out of 30 patients (57%) which were managed by catheterization.
Catheterization ; Catheters ; Classification ; Cystocele ; Daegu ; Follow-Up Studies ; Humans ; Postoperative Complications ; Urinary Incontinence* ; Urinary Retention ; Uterine Prolapse

OBJECTIVES: The most often perfomed major operation in gynecology is hysterectomy.Our purpose was to compare the indications, charateristics and outcomes of patients undergoing total abdominal hysterectomy and total vaginal hysterectomy and to help to establish guidelines to determine the route of hysterectomy. METHOD: The hospital charts of 400 women who underwent elective inpatient hysterectomy at Kyung-Hee University hospital from January 1994 to January 1999, were abstracted retrospectively. Data were collected regarding patients, age, parity, preoperative indications, the route of hysterectomy, uterine weight, operative and postoperative complications and the length of stay. The operative indications were benign uterine disease except from uterine prolapse. Bisection or combined morcellation were used in most cases to obtain reduction in uterine size. RESULT: Patients in whom the vaginal route was successful included 18% of those with uterine weights exceeding 280gm. There was statistically significant difference for uterine weight, operative time, bleeding amount, the length of stay in two camparative group. 4% of vaginal hysterectomy and 7% of total abdominal hysterectomy has documented operative complications. CONCLUSIONS: Vaginal hysterectomy is safe operation with few intraoperative and postoperative complications without notable blood loss. Vaginal hysterectomy allow one to shorten the operating time and allows early postoperative discharge of some patients from hospital. Skilled performance of vaginal hysterectomy is worth greater attention and should be used more often in gynecological study.
Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Inpatients ; Length of Stay ; Operative Time ; Parity ; Postoperative Complications ; Retrospective Studies ; Statistics as Topic* ; Uterine Diseases ; Uterine Prolapse ; Weights and Measures