COMPARISONS OF THE COMPLCAIONS INBETWEEN WOMEN WTH UTERINE PROLAPSE WHO UNDERWENT TOTAL VAGIALHYSTERECTOMY ONLY AND TRANSVAGINAL HYSTERECTOMY WITH ANTEIOR ANDPOSTERIOR COLPORRHAPHY
Gil Hosp., Incheon,Korea, Republic of.
Introduction: In women withuterine prolapse, transvaginal hysterectomy (TVH) is usually done toimprove the quality of life. Not in all women, but some cases havecystocele and rectocele together in women who had more numbers ofvaginal delivery. However, in women who only have uterine prolapsewithout cystocele or rectocele, there is a question whetherpracticing anterior or posterior coporrhaphy is mandatory.
Objective:In this study, we are to evaluate the surgical outcomes of uterineprolapse who did and did not have anterior or posterior vaginal wallprolapse.
Methods: Women who visited outpatient clinic dueto perineal mass and who were diagnosed with uterine prolapse betweenJanuary 2015 and December 2016 were included in this study. Accordingto the Pelvic Organ Quantification System (POPQ), stage equal to morethan 2 were included who do not have prominent cystocele orrectocele. All women underwent either TVH only (Group 1) or TVH withanterior and posterior repair (AP repair) (Group 2). Primary outcomewas to compare the surgical complications between the groups, and thesecondary outcome was to see the prevalence of the cystocele orrectocele who did not undergo AP repair.
Results: A total50 women with uterine prolapse with POP-Q equal to more than stage 2underwent surgical management. Thirty patients were in Group 1 and 20patients were in Group 2. The most common postoperative complicationwas vaginal discharges (Group 1 = 33.3 %, Group 2 = 15 %, p-value =0.752) which was present after 6 weeks of the operation in bothgroups. However in women who had delivered more than 3 children, inGroup 2, they revisited outpatient clinic due to cystocele orrectocele within 6 months to 18 months after the operation (N = 3cases, 15 %).
Conclusions: For managing uterine prolapse inwomen who do not have cystocele or rectocele, if they had deliveredmore than 3 children, prophylactic AP repair would berequired.
References: Cochrane Database Syst Rev. 2016 Oct1;10:CD012376Curr Urol Re. 2016 Nov;17(11):81Prog Urol. 2016 Jul;26Suppl 1:S98-S104Prog Urol. 2016 Jul;26 Suppl 1:S73-S88.Int UrogynecolJ. 2016 Nov;27(11):1619-1632