Comparison of recurrence rates with different surgical approaches for pelvic organ prolapse
DOI:
https://doi.org/10.15574/HW.2025.5(180).1520Keywords:
genital prolapse, vaginal surgery, laparoscopy, pelvic surgery, recurrenceAbstract
To date, there are insufficient data on the effectiveness of new laparoscopic approaches for the treatment of genital prolapse compared with vaginal surgery.
Aim - to determine the recurrence rate of genital prolapse after different surgical treatment options in women to compare the effectiveness of these treatment methods.
Materials and methods. The recurrence rate of genital prolapse was analyzed in 389 women, of whom 239 underwent vaginal surgery and 150 underwent laparoscopic surgical interventions. The types of interventions were as follows: for apical prolapse - vaginal hysterectomy (VH) without sacrospinous fixation and VH with sacrospinous fixation; for mixed prolapse - VH without sacrospinous fixation and VH with sacrospinous fixation; for apical prolapse - laparoscopic hysterectomy (LH) with promontofixation, with bilateral suspension, and with pectopexy; for mixed prolapse - laparoscopic LH with promontofixation and with pectopexy. Statistical analysis was performed using the SPSS 21 software.
Results. Laparoscopic surgical interventions for the correction of genital prolapse reduced the risk of recurrence from 34.7% to 18.7%, compared with vaginal surgery. Regardless of the type of genital prolapse, supplementation of vaginal hysterectomy with sacrospinous fixation was necessary, as it reduced the recurrence rate by 23.3% in apical prolapse and by 24.1% in mixed prolapse. The recurrence rate did not depend on the choice of the primary laparoscopic procedure in patients with apical prolapse; however, in cases of mixed prolapse, laparoscopic hysterectomy with promontofixation reduced the recurrence rate by 23.4%.
Conclusions. The obtained data indicate a higher effectiveness of various laparoscopic surgical approaches for the treatment of genital prolapse in women, as evidenced by a 1.9-time reduction in the risk of disease recurrence.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patients was obtained for conducting the studies.
The authors declare no conflict of interest.
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