THE ADVANTAGES OF INTRA-ABDOMINAL SACROCOLPORECTOPEXY COMBINED WITH STAPLED TRANCE ANAL RESECTION OF RECTAL MUCOSA IN SURGICAL TREEATMENT OF PELVIC ORGAN PROLAPSE

Author(s):  V.F. Kulikovsky, Dr., Prof., Belgorod National Research University, Belgorod, Russia

N.V. Oleynik, Dr., associate Professor, Belgorod National Research University, Belgorod, Russia, oleynik_nv@mail.ru

N.N. Bratisheva, Belgorod National Research University, Belgorod, Russia

A.P. Krinchikova, Belgorod National Research University, Belgorod, Russia

A.M. Abulatifa, Belgorod National Research University, Belgorod, Russia

M.S. Alenicheva, Belgorod National Research University, Belgorod, Russia

Issue:  Volume 41, №1

Rubric:  Clinical Medicine

Annotation:  The problem of pelvic organ prolapse in women is still actual due to the high prevalence of pathology and poor anatomical and functional results of treatment. The article presents investigations which improve the results of surgical treatment of this pathology. In 59 patients with pelvic prolapse manifested by rectocele, prolapse of perineum and the rectal mucosa prolapse intra-abdominal sacrocolpopexy with synthetic mesh implant was performed, in 52 patients with similar pathology sacrocolpopexy was augmented by stapled trance anal rectal resection (STARR). The results were evaluated after 6 months and 2 years with the use of POP-Q, defecography and functional tests. Analysis of postoperative complications showed that STARR surgery does not lead to an increase in complications associated with mesh implantation. A survey of patients on the system POP-Q showed a stage 0 prolapse in 22 (38.9 %) in the first group and 25 (48.1%) in the second group. The rest of the patients in both groups were achieved stage I. Radiologically it was marked the rise of the perineum body in both groups, reducing of the posterior anorectal angle, rectocele. However, in patients of the second group, these data were closer to normal. Disappearance of symptoms of rectal mucosa prolapse was achieved in 15 (25.4%) patients of the first group and in 47 (90.4%) patients of the second group (p=0.000). So, the emptying function has improved more in patients of the second group. So, intra-abdominal sacrocolpopexy can be a method of choice in the treatment of pelvic organ prolapse. However, with the combined nature of the prolapse, comprising in addition to rectocele and prolapse of the perineum, prolapse of the rectal mucosa sacrocolporectopexy along is not enough. The additional STARR (stapled transanal rectum resection) procedure improves anatomical and functional results of treatment.

Keywords:  pelvic prolapsed, sacrocolporectopexy, STARR procedure

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