The principle of choice of surgical techniques for the correction of genital prolapse in different age groups
I.I. MUSIN, A.G. JASHCHUK, R.M. ZAYNULLINA, R.A. NAFTULOVICH, E.M. POPOVA, A.G. IMELBAEVA, E.R. MECHTIEVA
Bashkir State Medical University of the Ministry of Health of the Russian Federation, 3 Lenina Str., Ufa, Russian Federation, 450008
Musin I.I. — Cand. Med. Sc., Assistant of the Department of Obstetrics and Gynecology No. 2, tel. +7-917-467-10-64, e-mail: ilnur-musin@yandex.ru
Yashchuk A.G. — D. Med. Sc., Professor, Head of the Department of Obstetrics and Gynecology No. 2, tel. (347) 264-96-50, e-mail: alfiya-galimovna@mail.ru
Zaynullina R.M. — Cand. Med. Sc., Associate Professor of the Department of Obstetrics and Gynecology No.2, tel. (347) 264-96-50, e-mail: raisa.bsmu@gmail.com
Naftulovich R.A. — Cand. Med. Sc., Associate Professor of the Department of Obstetrics and Gynecology No.2, tel. (347) 264-96-50, e-mail: raisanaftulovich@mail.ru
Popova E.M. — Assistant of the Department of Obstetrics and Gynecology No.2, tel. (347) 264-96-50, e-mail: ilnur-musin@yandex.ru
Imelbayeva A.G. — Assistant of the Department of Obstetrics and Gynecology No.2, tel. +7-917-777-40-06, e-mail: albina321093@rambler.ru
Mechtieva E.R. — clinical intern of the Department of Obstetrics and Gynecology No.2, tel. +7-919-606-98-85, e-mail: elvirochka-azn@mail.ru
As a result of the examination in women in the group I with the vaginal wall lowering without urodynamic disorders, vaginal plastic surgery and reconstruction of the pelvic floor with opening of the fascia of the bladder were performed; in conjunction with urodynamic disorders, urethropexy was performed with a mesh prosthesis, in addition, urethropexy with collagen material was executed when planning pregnancy. In patients with incomplete uterine prolapse surgical correction included fixation of the uterus with an aponeurotic flap. Examination of women in group II showed the following results: prolapse of the vaginal walls, prolapse of the cervical stump/vault of the vagina, including violation of urodynamics, incomplete uterine prolapse. Surgical correction was performed, including reconstruction of the pelvic floor and vaginal hysterectomy in combination with urethropexy mesh material. When the prolapse of the cervix cervix/vault of the vagina has been detected, were performed: sacrovaginopexy, including using a metal fixator, vaginal extirpation of the cervix stump. Patients of the older age group (more than 70 years) required surgical correction of the following pathological conditions: colpoptosis, almost all women, except for two, with violation of urodynamics, in some cases in combination with the dome of the vagina, incomplete and complete prolapse of the uterus and vagina. Patients of this group underwent vaginal hysterectomy, and also in some cases midline colporrhaphies in combination with urethropexy. Surgical correction of patients with genital prolapse should be conducted in specialized centers by trained specialists who possess all the methods of operative treatment of this complex pathology. A differentiated approach to the choice of the method of surgical treatment makes it possible to minimize both operational and postoperative complications.
Key words: genital prolapse, urethropexy, sacrovaginopexy, midline colporrhaphy.
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