Anterior vaginal duvar prolapsusunda meş cerrahisi ve ön onarım sonuçlarının karşılaştırılması

Amaç: Bu çalışmanın amacı anterior vaginal duvar prolapsusunda klasik ön onarım ile meş cerrahisi onarımın 12 aylık takip sonuçlarını karşılaştırmaktır.Gereç ve Yöntem: Bu retrospektif çalışma; Pelvik Organ Prolapsusu Sınıflandırma Sistemi’ne (POP-Q) göre Grade II veya üzerinde anterior vaginal kompartman defekti olan 69 semptomatik hasta ile yapıldı. Otuz-altı hastaya klasik ön onarım uygulandı (Grup 1), otuz-üç hastaya meş cerrahisi ile ön kompartman onarımı yapıldı (Grup 2). Operasyon şekli, süresi, 6. ve 12. aylarda hasta memnuniyetleri, objektif ve subjektif kür oranları, operasyon sonrası ağrı skorları görsel analog skala (VAS) kullanılarak kaydedildi.Bulgular: Hasta memnuniyeti Grup 2’de istatistiksel olarak anlamlı oranda fazlaydı. Cerrahi sonrası 12.aydaki objektif kür oranları Grup 2’de %87.8 ve Grup 1’de %61.1 bulundu. Fark istatistiksel olarak anlamlıydı. 12.aydaki subjektif kür oranları Grup 2’de %90.9 ve Grup 1’de %69.4 bulundu. Operasyon süresinin Grup 1’de istatistiksel olarak anlamlı oranda uzun olduğu saptandı. Gruplar arası ameliyatın ilk günü ve birinci yılı VAS ağrı skorlarında fark izlenmedi.Sonuç: Meş cerrahisi ile ön kompartman onarımı yüksek objektif kür oranları ve yüksek hasta memnuniyeti nedeniyle avantajlı görünmektedir.

Anahtar Kelimeler:

Pelvik organ prolapsusu, meş, meş onarımı, ön onarım, ön vaginal duvar, ön vaginal prolapsus

Comparison of anterior colporrhaphy and repair with mesh for anterior vaginal wall prolapse

Purpose: The aim of this study was to compare anterior colporrhaphy versus mesh repair as surgical management of anterior vaginal prolapse at the 12-months follow-up.Materials and Methods: This retrospective study was performed on 69 patients who were diagnosed with symptomatic anterior vaginal compartment defect (Grade II or higher) according to the Pelvic Organ Prolapse Quantification (POP-Q) system. Thirty-six of these patients underwent conventional colporrhaphy anterior (Group 1), thirty-three patients (Group 2) were treated with anterior repair via mesh application. Operation type and duration, patient satisfaction and objective and subjective cure rates, postoperative pain score using visual analog scale (VAS) scores were recorded at 6-months and 12-months.Results: Patient satisfaction was significantly higher in Group 2. Objective cure rates at 12-months after surgery were found 87.8% in Group 2 and 61.1% in Group 1; the difference was statistically significant. Subjective cure rates were determined as 90.9% in group 2 and 69.4% in Group 1. The duration of operation was confirmed to be significantly longer in the mesh group than Group 1. No significant differences were found between one day after and one year after surgery, in comparisons of our groups regarding VAS score for pelvic pain.Conclusion: The anterior repair with mesh procedure seems to be advantageous due to the higher objective cure rate and patient satisfaction for the treatment of anterior compartment defects.

Keywords:

Pelvic organ prolapse, mesh, mesh repair, anterior colporrhaphy, anterior vaginal wall, anterior vaginal prolapse,

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