This study was carried out in order to compare the effects in different surgeries using mesh in pelvic organ prolapse patients whose leading points were C. Thirty-nine patients were categorized into 3 groups: group A pelvic reconstruction with hysterectomy; group B hysterectomy prior to pelvic reconstruction; and group C pelvic reconstruction with uterus preserved. At first visit, POP-Q stage was determined, and age, BMI, admission days, operation time, post-operative stage and complications were observed and results were analyzed and compared. All patients who were operated upon converted to stage one month following the operation, and no further change was observed except in one patient. Group admission days were not significantly different, but tended to be lower in group C. Group average operation times between 'group A and B' and 'group A and C' were statistically different. No significant difference was observed in post-operative complications between the groups, but 3 members of group A developed erosion, whereas no erosion occurred in groups B and C. Pelvic reconstruction using mesh is a highly efficient method of treating pelvic organ prolapse. Improvements in stage and post-operative complications were not significantly different in the groups. However, uteropexy showed a shorter operation time, fewer admission days, and less erosion due to mesh than conventional pelvic reconstruction with hysterectomy.
Adult ; Aged ; Aged, 80 and over ; Comparative Study ; Female ; Humans ; Middle Aged ; Pelvis/surgery ; Reconstructive Surgical Procedures/*methods ; Retrospective Studies ; *Surgical Mesh ; Uterine Prolapse/*surgery ; Visceral Prolapse/*surgery

OBJECTIVETo discuss indications and therapeutic effects of concomitant surgery for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) through a retrospective clinical review.

METHODA retrospective review of the data of 16 women undergoing concomitant surgery for SUI and POP was available for analysis. In these cases, 12 patients presented with SUI symptoms associated with moderate or severe anterior vaginal wall prolapse; 4 patients had moderate or severe uterine prolapse associated with dysuria. All cases were confirmed to have type II stress urinary incontinence by preoperative physical examination, urodynamic study and cystography. The surgical procedures for pelvic floor repair included the placement of Gynemesh mesh implant, anterior or total Prolift mesh implant. The tension-free vaginal tape (TVT) or transvaginal tension free vaginal tape-obturator (TVT-O) was used for the anti-incontinence procedure. During the concurrent surgical procedures, pelvic floor repair was performed first.

RESULTSFollowed up from 6 to 30 months, all cases got satisfactory results. After the procedure, the patients achieved complete continence without occurrence of dysuria or recurrence of POP.

CONCLUSIONSStress incontinence and pelvic organ prolapse share common pathophysiologic etiologies and often coexist with one another. In SUI patients with symptomatic or moderate to severe POP, concurrent POP surgery should be performed actively at the time of incontinence surgery to prevent POP exacerbation and the occurrence of dysuria; while in patients with sole POP, occult SUI should be considered, and concomitant prophylactic incontinence measures should be taken at the time of POP repair to prevent the postoperative unmasking of SUI.

Aged ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Pelvic Floor ; surgery ; Retrospective Studies ; Suburethral Slings ; Urinary Incontinence, Stress ; complications ; surgery ; Visceral Prolapse ; complications ; surgery