Pelvik organ prolapsusu için iliokoksigeal fiksasyon prosedürünün değerlendirilmesi: preoperatif özellikler ve kısa dönem postoperatif sonuçlar
Yıl 2024,
, 111 - 116, 30.08.2024
Emre Köle
,
İlaha Hasanova
,
Ramazan Oğuz Şahin
,
Esra Ayanoğlu
,
Lale Aksoy
,
Alparslan Deniz
,
Erdoğan Aslan
Öz
Amaç: Bu çalışmada; pelvik organ proplapsusu (POP) nedeniyle, cerrahi tedavisi için iliokoksigeal fiksasyon (ICF) uyguladığımız hastaların kısa dönem sonuçlarını araştırmayı ve ICF prosedürünün güvenirliğini ve uygulanabilirliğini değerlendirmeyi amaçladık.
Hastalar ve Yöntemler: Çalışmamız 01.04.2022 ve 31.03.2024 tarihleri arasında kliniğimizde ICF uygulanan 50 POP hastasının verileri retrospektif olarak değerlendirilmiştir. Toplam 44 hasta çalışmada değerlendirme kriterlerine uygun bulundu. Hastaların demografik verileri ile preoperatif ve postoperatif 3. Aydaki klinik verileri değerlendirildi.
Bulgular: Çalışmamızın bulgularına göre, NSD ve CS hastalarında ortanca ameliyat süresi arasındaki fark istatistiksel olarak anlamlıdır ve NSD hastalarında ameliyat süresi daha uzundur (80 dakika (70-85) vs 60 dakika (50 -67,5), (p<0,05)). Sadece bir rekürrens, bir hematom ve enfeksiyon ve bir mesane yaralanması meydana geldi.
Sonuç: Çalışmamıza göre, ICF güvenli, dayanıklı ve diğer prosedürlerle birlikte yapılabilen cerrahi olarak uygulanabilir bir prosedürdür. Bu nedenle, SSLF' nin birçok ciddi komplikasyonunu önlediği için ideal yöntem bulunana kadar bu prosedürü şiddetle savunuyoruz.
Kaynakça
- 1. Fritel X, Varnoux N, Zins M, Breart G, Ringa V. Symptomatic pelvic organ prolapse at midlife, quality of life, and risk factors. Obstet Gynecol. 2009;113(3):609-616. doi: 10.1097/AOG.0b013e3181985312
- 2. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997; 89:501–6. https://doi.org/10.1016/S0029-7844(97)00058-6
- 3. Cespedes RD. Anterior approach bilateral sacrospinous ligament fixation for vaginal vault prolapse. Urology 2000; 56, 6, 1:70–5. https://doi.org/10.1016/s0090-4295(00)00919-5.
- 4. Declas E, Giraudet G, Delplanque S, Rubod C, Cosson M. How we perform a posterior sacrospinous ligament fixation by the vaginal route. Int Urogynecology J 2020; 31(7):1479–81. https://doi.org/10.1007/s00192-019-04149-8.
- 5. Schulten SF, Detollenaere RJ, Stekelenburg J, IntHout J, Kluivers KB, van Eijndhoven HW. Sacrospinous hysteropexy versus vaginal hysterectomy with uterosacral ligament suspension in women with uterine prolapse stage 2 or higher: observational follow-up of a multicentre randomised trial. bmj 2019, 366. doi: 10.1136/bmj.l5149
- 6. Zhang W, Cheon WC, Zhang L, Wang X, Wei Y, Lyu C. Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis. Int Urogynecol J. 2022;33(1):3–13. doi: 10.1007/s00192-021-04823-w
- 7. Paraiso MF, Ballard LA, Walters MD, Lee JC, Mitchinson AR. Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol. 1996 Dec;175(6):1423-30; discussion 1430-1. doi: 10.1016/s0002-9378(96)70085-6. PMID: 8987920.
- 8. Medina CA, Croce C, Candiotti K, Takacs P. Comparison of vaginal length after iliococcygeus fixation and sacrospinous ligament fixation. Int J Gynaecol Obstet. 2008 Mar;100(3):267-70. doi: 10.1016/j.ijgo.2007.09.018. Epub 2007 Nov 26. PMID: 18022624
- 9. Sze EH, Karram MM. Transvaginal repair of vault prolapse: a review. Obstet Gynecol. 1997;89(3):466–75. doi: 10.1016/S0029-7844(96)00337-7
- 10. Biler A, Ertaş İE, Tosun G, et al. Perioperative complications and short-term outcomes of abdominal sacrocolpopexy, laparoscopic sacrocolpopexy, sacrospinous ligament fixation, and iliococcygeus fixation procedures. Turk J Med Sci. 2018;48(3):602-610. doi: 10.3906/sag-1712-203.
- 11. Serati M, Salvatore S, Athanasiou S, et al. Ten years' follow-up after iliococcygeus fixation for the treatment of apical vaginal prolapse. Int Urogynecol J. 2021; 32(6): 1533-1538. doi:10.1007/s00192-020-04598-6
- 12. Aslan A. [Systematic Reviews and Meta-Analyses]. Acta Med. Alanya 2018;2(2):62-63. doi: 10.30565/medalanya.439541
- 13. Aslan A. [Evidence Based Medicine and Clinical Practise Guidlines]. Acta Med. Alanya 2018;1(1):1-2. doi: 10.30565/medalanya.405333
Evaluation of iliococcygeal fixation procedure for pelvic organ prolapse: preoperative properties and short term postoperative outcomes
Yıl 2024,
, 111 - 116, 30.08.2024
Emre Köle
,
İlaha Hasanova
,
Ramazan Oğuz Şahin
,
Esra Ayanoğlu
,
Lale Aksoy
,
Alparslan Deniz
,
Erdoğan Aslan
Öz
Aim: The aim of this study was to evaluate the short-term outcomes of patients who underwent iliococcygeal fixation (ICF) for the surgical treatment of pelvic organ prolapse (POP) and to assess the safety and feasibility of the ICF procedure.
Patients and Methods: Our study is retrospectively done with the data of 50 POP patients who underwent ICF in our clinic within the dates 01.04.2022 and 31.03.2024. A total of 44 women were found to be eligible for follow-up. Demographic data and pre- and post-operative clinical data at 3 months were assessed.
Results: According to the findings of our study, the difference between the median duration of surgery in NSD and CS patients is statistically significant, and the duration of surgery is longer in NSD patients (80 minutes (70-85) vs 60 minutes (50 -67,5), (p<0,05)). Only one recurrence, one hematoma and infection, and one bladder injury had occurred.
Conclusion: According to our study, ICF is a safe, durable and surgically feasible procedure that can be done concomitantly with other procedures. Thus, we strongly advocate this procedure until the ideal mesh is found since it avoids many serious complications of SSLF.
Etik Beyan
The approval of Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital Clinical Research Ethics Committee (decision dated 12.06.2024 and numbered 174).
Kaynakça
- 1. Fritel X, Varnoux N, Zins M, Breart G, Ringa V. Symptomatic pelvic organ prolapse at midlife, quality of life, and risk factors. Obstet Gynecol. 2009;113(3):609-616. doi: 10.1097/AOG.0b013e3181985312
- 2. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997; 89:501–6. https://doi.org/10.1016/S0029-7844(97)00058-6
- 3. Cespedes RD. Anterior approach bilateral sacrospinous ligament fixation for vaginal vault prolapse. Urology 2000; 56, 6, 1:70–5. https://doi.org/10.1016/s0090-4295(00)00919-5.
- 4. Declas E, Giraudet G, Delplanque S, Rubod C, Cosson M. How we perform a posterior sacrospinous ligament fixation by the vaginal route. Int Urogynecology J 2020; 31(7):1479–81. https://doi.org/10.1007/s00192-019-04149-8.
- 5. Schulten SF, Detollenaere RJ, Stekelenburg J, IntHout J, Kluivers KB, van Eijndhoven HW. Sacrospinous hysteropexy versus vaginal hysterectomy with uterosacral ligament suspension in women with uterine prolapse stage 2 or higher: observational follow-up of a multicentre randomised trial. bmj 2019, 366. doi: 10.1136/bmj.l5149
- 6. Zhang W, Cheon WC, Zhang L, Wang X, Wei Y, Lyu C. Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis. Int Urogynecol J. 2022;33(1):3–13. doi: 10.1007/s00192-021-04823-w
- 7. Paraiso MF, Ballard LA, Walters MD, Lee JC, Mitchinson AR. Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction. Am J Obstet Gynecol. 1996 Dec;175(6):1423-30; discussion 1430-1. doi: 10.1016/s0002-9378(96)70085-6. PMID: 8987920.
- 8. Medina CA, Croce C, Candiotti K, Takacs P. Comparison of vaginal length after iliococcygeus fixation and sacrospinous ligament fixation. Int J Gynaecol Obstet. 2008 Mar;100(3):267-70. doi: 10.1016/j.ijgo.2007.09.018. Epub 2007 Nov 26. PMID: 18022624
- 9. Sze EH, Karram MM. Transvaginal repair of vault prolapse: a review. Obstet Gynecol. 1997;89(3):466–75. doi: 10.1016/S0029-7844(96)00337-7
- 10. Biler A, Ertaş İE, Tosun G, et al. Perioperative complications and short-term outcomes of abdominal sacrocolpopexy, laparoscopic sacrocolpopexy, sacrospinous ligament fixation, and iliococcygeus fixation procedures. Turk J Med Sci. 2018;48(3):602-610. doi: 10.3906/sag-1712-203.
- 11. Serati M, Salvatore S, Athanasiou S, et al. Ten years' follow-up after iliococcygeus fixation for the treatment of apical vaginal prolapse. Int Urogynecol J. 2021; 32(6): 1533-1538. doi:10.1007/s00192-020-04598-6
- 12. Aslan A. [Systematic Reviews and Meta-Analyses]. Acta Med. Alanya 2018;2(2):62-63. doi: 10.30565/medalanya.439541
- 13. Aslan A. [Evidence Based Medicine and Clinical Practise Guidlines]. Acta Med. Alanya 2018;1(1):1-2. doi: 10.30565/medalanya.405333