H Azaïs1, C Jean Charles, P Delporte, P Debodinance. 1. Department of Obstetrics and Gynecology-Dunkirk Hospital Center, GCS Flandre Maritime, av de la Polyclinique, 59760 Grande Synthe, France.
Abstract
INTRODUCTION AND HYPOTHESIS: The aim of this study was to examine the anatomical and functional results of prolapse repair by a vaginal approach using the Elevate kit. METHODS: This was a prospective study of 70 patients presenting with symptomatic urogenital prolapse. Twenty Elevate Anterior, 16 Posterior, and 34 Anterior and Posterior repair systems were placed. Perioperative and postoperative complications were assessed. The patients were interviewed at 2 months and 1 year post-surgery. RESULTS: Recurrences were recorded in 21 patients (31.3%) at the 1-year follow-up. However, at the 1-year follow-up, there were 14 cases (20.9%) of direct recurrence (two anterior, two posterior, and ten combined anterior and posterior) compared with seven cases (10.4%) of indirect recurrence. Of the 21 failures (stage ≥ 2), 13 were stage 2 with the leading edge above the hymen. None of the patients underwent revision surgery. The exposure rate was 4.5%. The anterior and posterior shrinkage rates were 68.7% and 31.9%, respectively. There were four cases of de novo dyspareunia. Patients reported a significant decrease in the impact of pelvic floor distress on the PFIQ-7 questionnaire, but an improvement on the PFDI-20. There was no improvement in sexual function (PISQ-12). CONCLUSIONS: The Elevate™ kit is associated with satisfactory functional results. However, the anatomical results require ongoing evaluation.
INTRODUCTION AND HYPOTHESIS: The aim of this study was to examine the anatomical and functional results of prolapse repair by a vaginal approach using the Elevate kit. METHODS: This was a prospective study of 70 patients presenting with symptomatic urogenital prolapse. Twenty Elevate Anterior, 16 Posterior, and 34 Anterior and Posterior repair systems were placed. Perioperative and postoperative complications were assessed. The patients were interviewed at 2 months and 1 year post-surgery. RESULTS: Recurrences were recorded in 21 patients (31.3%) at the 1-year follow-up. However, at the 1-year follow-up, there were 14 cases (20.9%) of direct recurrence (two anterior, two posterior, and ten combined anterior and posterior) compared with seven cases (10.4%) of indirect recurrence. Of the 21 failures (stage ≥ 2), 13 were stage 2 with the leading edge above the hymen. None of the patients underwent revision surgery. The exposure rate was 4.5%. The anterior and posterior shrinkage rates were 68.7% and 31.9%, respectively. There were four cases of de novo dyspareunia. Patients reported a significant decrease in the impact of pelvic floor distress on the PFIQ-7 questionnaire, but an improvement on the PFDI-20. There was no improvement in sexual function (PISQ-12). CONCLUSIONS: The Elevate™ kit is associated with satisfactory functional results. However, the anatomical results require ongoing evaluation.
Authors: P K Sand; S Koduri; R W Lobel; H A Winkler; J Tomezsko; P J Culligan; R Goldberg Journal: Am J Obstet Gynecol Date: 2001-06 Impact factor: 8.661