Do Pelvic Organ Prolapse Quantification Examination Ba and D Guide the Selection of Operation for Severe Pelvic Organ Prolapse?
Purpose: To determine whether the preoperative Ba and D point could help to guide the choice of surgical procedure for POP. Materials and Methods: This prospective cohort study included 250 subjects with anterior/apical defect from January 2012 to June 2015. All subjects underwent a complete preoperative evaluation and completed 12 months of follow-up. Based on the connection of preoperative Ba and D point of Pelvic Organ Prolapse Quantification (POP-Q), patients were assigned two groups: 137 patients who underwent anterior vaginal repair with mesh (AVM) and 113 patients who underwent AVM combined with sacrospinous ligament fixation (SSLF). The primary outcomes were anatomical cure and recurrence rate of both procedures. Secondary outcomes were prolapse symptom, quality of life and sexual function based upon validated questionnaires. The complications were also recorded in both groups. Results: Both groups were homogeneous preoperatively. The anatomical success rates for the anterior, apical and posterior vaginal compartments were 99.2%, 97.0% and 97.7% in the AVM group, respectively. For patients who underwent AVM-SSLF, the anatomical success rates for the anterior, apical and posterior compartments were 96.1%, 98.1% and 98.1%, respectively. The recurrence for both techniques was low. Both procedures presented a significant improvement with regard to postoperative quality of life (QOL), prolapse symptoms, and sexual function after 1-year follow-up. Conclusion: The preoperative Ba and D point correlated with surgical choice for the treatment of anterior/apical prolapse, which further decided the surgical outcomes for prolapse support.
['Li|Chunbo|C|', 'Shu|Huimin|H|', 'Dai|Zhiyuan|Z|']
D000368:Aged D000066491:Clinical Decision-Making D005260:Female D005500:Follow-Up Studies D013509:Gynecologic Surgical Procedures D006801:Humans D008022:Ligaments D008875:Middle Aged D018579:Patient Selection D017773:Pelvic Floor D056887:Pelvic Organ Prolapse D011183:Postoperative Complications D011184:Postoperative Period D011300:Preoperative Care D011446:Prospective Studies D011788:Quality of Life D012008:Recurrence D012720:Severity of Illness Index D012725:Sexual Behavior D053825:Suburethral Slings D013526:Surgical Mesh D011795:Surveys and Questionnaires D016896:Treatment Outcome D014621:Vagina
pelvic organ prolapse mesh sacrospinous ligament suspension surgery vaginal surgery