Kolpoklezis Ameliyatının Postoperatif 12. Ayda Fonksiyonel ve Anatomik Sonuçları

Amaç: Kolpoklezis özellikle ileri yaştaki kadın hastalarda pelvik organ prolapsusu tedavisinde vajinanın oblitere edilmesi yöntemi ile yapılan bir ameliyattır. Araştrmanın amacı kolpoklezis ameliyatından 12 ay sonra pelvik organ prolapsusu semptomlarında, işeme ve defekasyon ile ilgili semptomlarda iyileşme, anatomik başarı, cerrahi memnuniyet ve ameliyat sonrası pişmanlığı değerlendirmek. Gereç ve Yöntemler: 2013-2016 yılları arasında Turgut Özal Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalında kolpoklezis ameliyatı yapılan ve yıllık kontrolerinde muayene edilen 22 hastanın sonuçları retrospektif olarak incelendi. Hastalara preoperatif ve postoperatif 1. yılda pelvik organ prolapsusu değerlendirme muayenesi (POP-Q) ve pelvik taban distress anketi-20 (PFDI-20) uygulandı ve postoperative 1. yılda ‘ameliyat sonrasında pişmanlık yaşadınız mı?’ sorusunu içeren postoperatif ameliyat memnuniyet anketi (SSQ-8) uygulandı Bulgular: Kolpoklezis ameliyatından 1 yıl sonra PFDI-20 skorlarında iyileşme izlendi (p < 0.001), tüm hastaların POP-Q sistemine göre evresi ≤1’di. Ameliyat sonrası memnuniyet skoru 86’ydı. Vajen obliterasyonuna bağlı pişmanlık hiçbir hastada izlenmedi. Sonuç: Kolpoklezis ameliyatından 12 ay sonra anatomik ve foksiyonel sonuçlar tatmin edicidir.

Functional and Anatomical Results of Colpocleisis 12 Months After the Surgery

Objective: Colpocleisis is a vaginal obliterative procedure that is performed for the treatment of pelvic organ prolapse (POP), especially in elderly women. To evaluate the anatomical success rate, improvements in POP symptoms and urinary and defaecatory symptoms, and surgical satisfaction and regret of patient 12 months after colpocleisis.Material and Methods: Twenty-two females who underwent colpocleisis during 2013–2016 were evaluated retrospectively. Assessment of the pelvic organ prolapse quantification (POP-Q) system and the Pelvic Floor Distress Inventory (PFDI-20) preoperatively and at 1 year after surgery; the Surgical Satisfaction Questionnaire (SSQ-8) that include question related with the regret of surgery was also completed 1 year after surgery.Results: Significant improvements in the total PFDI-20 score and subscale scores (all p < 0.001) were evident 1 year after colpocleisis; the POP-Q stage of all patients was ≤1, the SSQ-8 total score was 86. There is no regret because of the loss of sexual intercourse.Conclusion: The anatomical and functional outcomes of colpocleisis were satisfactory 12 months after surgery.

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J. M. Wu, A. F. Hundley, R. G. Fulton, and E. R. Myers, “Forecasting the Prevalence of Pelvic Floor Disorders in U.S. Women,” Obstet. Gynecol., vol. 114, no. 6, pp. 1278–1283, 2009.
A. L. Smith, D. R. Karp, R. Lefevre, V. C. Aguilar, and G. W. Davila, “LeFort colpocleisis and stress incontinence: Weighing the risk of voiding dysfunction with sling placement,” Int. Urogynecol. J., vol. 22, no. 11, pp. 1357–1362, 2011.
S. T. Celenay, T. Akbayrak, S. Kaya, G. Ekici, and S. Beksac, “Validity and reliability of the Turkish version of the Pelvic Floor Distress Inventory-20,” Int. Urogynecol. J., vol. 23, no. 8, pp. 1123–1127, 2012.
M. D. Barber, M. D. Walters, and R. C. Bump, “Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7),” Am. J. Obstet. Gynecol., vol. 193, no. 1, pp. 103–113, 2005.
R. E. Haff, J. Stoltzfus, V. R. Lucente, and M. Murphy, “The Surgical Satisfaction Questionnaire (SSQ-8): A Validated Tool for Assessment of Patient Satisfaction Following Surgery To Correct Prolapse and/or Incontinence,” J. Minim. Invasive Gynecol., vol. 18, no. 6, pp. S49–S50, 2011.
G. Buchsbaum and T. Gee Lee, “Vaginal Obliterative Procedures for Plevic Organ Prolapse: A Systematic Review,” Obstet. Gynecol. Surv., vol. 72, no. 3, pp. 175–183, 2017.
C. Yasa, F. G. Ugurlucan, and O. Yalcin, “Management of pyometra after LeFort colpocleisis resistant to drainage,” Int. Urogynecol. J., vol. 27, no. 4, pp. 645–646, 2016.
X. Wang, Y. Chen, and K. Hua, “Pelvic Symptoms, Body Image, and Regret after LeFort Colpocleisis: A Long-Term Follow-Up,” J. Minim. Invasive Gynecol., vol. 24, no. 3, pp. 415–419, 2017.
R. D. Moore and J. R. Miklos, “Colpocleisis and tension-free vaginal tape sling for severe uterine and vaginal prolapse and stress urinary incontinence under local anesthesia,” J. Am. Assoc. Gynecol. Laparosc., vol. 10, no. 2, pp. 276–280, 2003.
C. C. Crisp et al., “Body image, regret, and satisfaction following colpocleisis,” Am. J. Obstet. Gynecol., vol. 209, no. 5, p. 473.e1-473.e7, 2013.
F. Edalat, “NIH Public Access,” vol. 40, no. 6, pp. 1301–1315, 2012.
S. C. Ng and G. Den Chen, “Obliterative LeFort colpocleisis for pelvic organ prolapse in elderly women aged 70 years and over,” Taiwan. J. Obstet. Gynecol., vol. 55, no. 1, pp. 68–71, 2016.
M. R. Asoglu, S. Selcuk, C. Cam, R. Ayaz, N. Tug, and A. Karateke, “Colpocleisis, patient satisfaction and quality of life,” J. Turkish Ger. Gynecol. Assoc., vol. 13, no. 4, pp. 253–256, 2012.
C. Reisenauer, E. Oberlechner, B. Schoenfisch, D. Wallwiener, and M. Huebner, “Modified LeFort colpocleisis: Clinical outcome and patient satisfaction,” Arch. Gynecol. Obstet., vol. 288, no. 6, pp. 1349–1353, 2013.
M. Murphy, G. Sternschuss, R. Haff, H. van Raalte, S. Saltz, and V. Lucente, “Quality of life and surgical satisfaction after vaginal reconstructive vs obliterative surgery for the treatment of advanced pelvic organ prolapse,” Am. J. Obstet. Gynecol., vol. 198, no. 5, pp. 1–7, 2008.
K. Bochenska, A. Leader-Cramer, M. Mueller, B. Davé, A. Alverdy, and K. Kenton, “Perioperative complications following colpocleisis with and without concomitant vaginal hysterectomy,” Int. Urogynecol. J., vol. 28, no. 11, pp. 1671–1675, 2017.