Comparative analysis of laparoscopic techniques for correction of apical prolapse
A.G. TYAN2, YU.E. DOBROKHOTOVA1, I.A. LAPINA1, V.V. TARANOV1, T.G. CHIRVON1, N.V. GLEBOV2, O.V. KAJKOVA2
1Pirogov Russian National Research Medical University, Moscow
2MEDSI Clinical and Diagnostic Center, Moscow
Contact details:
Taranov V.V. — PhD (medicine), Assistant Lecturer at the Department of Obstetrics and Gynecology
Address: 1 Ostrovityanova St., 117997 Moscow, Russian Federation, tel.: +7-968-814-70-92, e-mail: doctortaranov@yandex.ru
The variety of options for reconstructive correction of genital prolapse demonstrates the lack of a universal treatment method and the urgency of searching for the most advanced options in order to reduce the risk of recurrence and complications.
The purpose — comparative evaluation of the results of surgical treatment of genital prolapse using laparoscopic lateral fixation and pectopexy.
Material and methods. A comparative analysis of the results of treatment of apical and antero-apical genital prolapse using laparoscopic access was performed. The first group consisted of patients who underwent lateral fixation (n = 20), the second group included patients who underwent pectopexy (n = 20).
Results. As a result of 1 year of follow-up in the postoperative period, it was noted that both techniques were associated with a significant improvement in quality of life (the sum of PFDI scores before surgery in group 1 was 122.1, after 12 months 11.5; in the second group 117.5 and 12.2, respectively). At the same time, recurrence of apical prolapse was rare (not more than 5% in both groups), whereas cystocele of stage 2 or more 12 months after surgery was more frequent among patients of the second group (5% in the first group and 15% in the second group).
Conclusion. Laparoscopic lateral fixation and pectopexy make it possible to correct the apical defect with minimal risk of recurrence. In the presence of concomitant cystocele, lateral hysteropexy is preferable.
Key words: lateral hysteropexy, laparoscopic pectopexy, genital prolapse, apical prolapse, cystocele.
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