COMPARATIVE OUTCOME BETWEEN VAGINAL AND ABDOMINAL APPROACHES IN PELVIC ORGAN PROLAPSE SURGERY
Main Article Content
Keywords
Pelvic organ prolapse, vaginal surgery, abdominal surgery, recurrence, sexual function, surgical outcomes
Abstract
Introduction: The purpose of this paper is to explain the concept of POP, which is a prevalent condition in women whereby the organs in the female pelvic region shift due to non-supportive pelvic floor muscles. Vaginal and abdominal surgical approaches of POP have been identified to differ in the level of effectiveness, risks and effects on sexual satisfaction. This project aims to classify the case as to patients' surgery results versus expected surgery results to aid in decision-making.
Objectives: The purpose and aim of this trial were to evaluate and compare the degree of surgical success, complications, sexual quality of life and recurrence rate between vaginal and Abdominal approaches of POP surgery.
Materials and Methods: A cross-sectional observational study was proposed at Jinnah Postgraduate Medical Centre, Karachi, Pakistan, for the period of January to June 2024. The subjects included were 100 patients where 50 of them were those that underwent vaginal surgery, and the other 50 were those that underwent abdominal surgery. They also analysed the operative time and postoperative hospital stay, postoperative complications, and sexual function of the patients.
Results: Vaginal surgery gives shorter operative time and quicker ambulation, whereas abdominal surgery has less rate of recurrence and a better survival curve.
Conclusion: The two procedures each have some advantages and hence should be recommended depending on the degree of prolapse and preferences of the patient.
References
2- Antosh, D.D., Dieter, A.A., Balk, E.M., Kanter, G., Kim-Fine, S., Meriwether, K.V., Mamik, M.M., Good, M.M., Singh, R., Alas, A. and Foda, M.A., 2021. Sexual function after pelvic organ prolapse surgery: a systematic review comparing different approaches to pelvic floor repair. American journal of obstetrics and gynecology, 225(5), pp.475-e1.
3- Larouche, M., Belzile, E. and Geoffrion, R., 2021. Surgical management of symptomatic apical pelvic organ prolapse: a systematic review and meta-analysis. Obstetrics & Gynecology, 137(6), pp.1061-1073.
4- Li, S., Wen, X., Gao, Z., Ke, K., Yang, J., Wang, H., Mo, Y., Zeng, Y., Li, Y., Tian, D. and Shen, J., 2022. Comparison of the axes and positions of the uterus and vagina between women with and without pelvic floor organ prolapse. Frontiers in Surgery, 9, p.760723.
5- Chaudhary, T. and Paliwal, S., 2024. Perioperative Complications and Short‐Term Outcomes in Abdominal Laparoscopic Versus Vaginal Vault Prolapse Surgeries: A Comparative Analysis. Res. J. Med. Sci, 18, pp.431-435.
6- Chen, Y., Zhou, Y., Tan, L., Chen, S., Wu, C., Liang, Y., Sun, N. and Liu, J., 2023. Comparative analysis of transvaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site sacrocolpopexy for pelvic organ prolapse: A propensity score matching study. Heliyon, 9(9).
7- Okcu, N.T., Gürbüz, T. and Uysal, G., 2021. Comparison of patients undergoing vaginal hysterectomy with sacrospinous ligament fixation, laparoscopic hysterectomy with sacrocolpopexy and abdominal hysterectomy with sacrocolpopexy in terms of postoperative quality of life and sexual function. Journal of Gynecology Obstetrics and Human Reproduction, 50(4), p.101977.
8- Murphy, A.M., Clark, C.B., Denisenko, A.A., D’Amico, M.J. and Vasavada, S.P., 2021. Surgical management of vaginal prolapse: current surgical concepts. Can J Urol, 28(S2), pp.22-6.
9- Pecorella, G., Morciano, A., Sparic, R. and Tinelli, A., 2024. Literature review, surgical decision making algorithm, and AGREE II‐S comparison of national and international recommendations and guidelines in pelvic organ prolapse surgery. International Journal of Gynecology & Obstetrics.
10- van der Vaart, L.R., Vollebregt, A., Pruijssers, B., Milani, A.L., Lagro-Janssen, A.L., Roovers, J.P.W. and van der Vaart, C.H., 2022. Female sexual functioning in women with a symptomatic pelvic organ prolapse; A multicenter prospective comparative study between pessary and surgery. The journal of sexual medicine, 19(2), pp.270-279.
11- Sliwa, J., Kryza-Ottou, A., Grobelak, J., Domagala, Z. and Zimmer, M., 2021. Anterior abdominal fixation—a new option in the surgical treatment of pelvic organ prolapse. Ginekologia Polska, 92(7), pp.471-474.
12- Ciortea, R., Roman, M.P., Măluțan, A.M., Bucuri, C.E., Ormindean, C.M., Nati, I.D. and Mihu, D., 2023. Comparison of laparoscopic sacrocolpopexy with vaginal reconstructive procedures and abdominal sacrocolpopexy for the surgical management of vaginal vault prolapse: a systematic review and meta-analysis. Frontiers in Medicine, 10, p.1269214.
13- Chan, C.Y.W., Fernandes, R.A., Yao, H.H.I., O’Connell, H.E., Tse, V. and Gani, J., 2023. A systematic review of the surgical management of apical pelvic organ prolapse. International Urogynecology Journal, 34(4), pp.825-841.
14- Kotani, Y., Murakamsi, K., Kai, S., Yahata, T., Kanto, A. and Matsumura, N., 2021. Comparison of surgical results and postoperative recurrence rates by laparoscopic sacrocolpopexy with other surgical procedures for managing pelvic organ prolapse. Gynecology and Minimally Invasive Therapy, 10(4), pp.221-225.
15- Obut, M., Oğlak, S.C. and Akgöl, S., 2021. Comparison of the quality of life and female sexual function following laparoscopic pectopexy and laparoscopic sacrohysteropexy in apical prolapse patients. Gynecology and Minimally Invasive Therapy, 10(2), pp.96-103.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Shazia
Consultant Gynecologist, Department of Obstetrics and Gynaecology, Scouts Hospital Wana South Waziristan, Pakistan
Dr Mona Kanwal Naz
Associate Professor of Obstetrics & Gynaecology, Cantt General Hospital, Rawalpindi, Pakistan
Dr Aneesa Sadiq
Assistant Professor, Gajju Khan Medical College, Shahmansoor, Pakistan.
Dr Ghulam Fiza Nida Badar
Assistant Professor, Department of Obstetrics and Gynaecology, GIMS Gambat, Pakistan
Dr Fatima Bibi
Senior Registrar, Department of Obstetrics and Gynaecology, Ziauddin University Karachi, Pakistan
Dr Surraya Israr
Associate Professor, Department of Obstetrics and Gynaecology, GKMC /BKMC Swabi, Pakistan