Postoperative pelvic dysfunctions associated with the reconstruction of the pelvic floor.

Abstract

Background: The authors were aiming to conduct the comparative analysis of the frequency of formation of pelvic dysfunctions after surgical correction of genitalia prolapse in women by a vaginal approach using native tissue repair of the vaginal paries and synthetic implants.

Methods: The study included 546 patients with stage II-IV genitalia prolapse according to the POP-Q classification. The quality of life was assessed using PD-QL and PFIQ-7 questionnaires. The 1st group included patients after native tissue repair (N.=314), the 2^nd - after surgery with the use of synthetic implants (N.=232).

Results: In the 1^st group de-novo dysfunctions were revealed as follows: stress urinary incontinence: in 4.9% of women, urgency: in 2.2%, obstructive urination: in 8.0%; constipation or fecal and flatal incontinence: none. The index of pelvic floor dysfunction decreased from 50±14% to 8±2%. The index of influence on the quality of life decreased from 81±14% to 9% after 12 months. In the 2^nd group, de-novo dysfunctions were revealed as follows: stress urinary incontinence: in 9.5% of women, urgency: in 9.1%, obstructive urination: in 23.7%; constipation or fecal and flatal incontinence: 1 patient (0.4%). In patients of the 2^nd group, there was a decrease in the pelvic floor dysfunction index from 48±12% to 10±2%. The index of influence on the quality of life decreased from 79±15% to 5% after 12 months.

Conclusions: The use of synthetic implants causes the formation of de novo pelvic dysfunctions more often than the native tissue repair.