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Severe pelvic organ prolapse treated by vaginal native tissue repair: long-term analysis of outcomes in 146 patients

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Aims

The aim of this study was to assess the effectiveness and safety of vaginal native tissue repair (VNTR) as a surgical treatment for severe pelvic organ prolapse (POP) and, second, to evaluate the impact on the quality-of-life (QoL) and sexual function.

Methods

Women with symptomatic POP (≥III stage according to POP Quantification System) with or without stress urinary incontinence (SUI) underwent VNTR. The clinical stage, 3-day voiding diary, and urodynamic testing were evaluated in the preoperative and postoperative times, respectively. The International Consultation on Incontinence Questionnaire–Urinary Incontinence Questionnaire Short Form (ICIQ–UI SF), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12), and the prolapse quality-of-life questionnaire (P-QoL) were administered.

Results

One hundred forty-six patients were recruited. The median follow-up was 48 months (36–63). Fifty-two women (36%) had a previous hysterectomy, and 16 (11%) had a previous prolapse/continence surgery. Preoperatively, 135 (92.5%), 109 (74.7%), and 98 (67.1%) patients had anterior, central, and posterior descent ≥III stage, respectively. Thirty-two patients (22%) had concomitant diagnosis of SUI. Median operative time was 85 min (37–154), and median postoperative hospital stay was 2 days (2–4). No intraoperative severe complications occurred. At the long-term follow-up, the subjective cure rate for prolapse was 97.3% and the objective cure rate was 91.1%. A significant improvement of ICIQ-UI SF, the P-QoL, and the PISQ-12 was recorded at the follow-up (p < 0.001).

Conclusion

VNTR is effective, safe, and durable and improves POP-related symptoms and sexual function.

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Authors and Affiliations

  1. Department of Gynecology, Obstetrics and Urology, Umberto I, ‘‘Sapienza’’ University of Rome, Rome, Italy

    Michele Carlo Schiavi, Giorgia Perniola, Violante Di Donato, Virginia Sibilla Visentin, Flaminia Vena, Anna Di Pinto, Marco Monti & Pierluigi Benedetti Panici

  2. Department of Surgery-Week Surgery, Campus Biomedico, University of Rome, Rome, Italy

    Marzio Angelo Zullo

  3. Department of Gynecological and Obstetric Sciences, and Urological Sciences, Umberto I Hospital, University of Rome “Sapienza”, Viale del Policlinico 155, 00161, Rome, Italy

    Michele Carlo Schiavi

Authors
  1. Michele Carlo Schiavi
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  2. Giorgia Perniola
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  3. Violante Di Donato
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  4. Virginia Sibilla Visentin
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  9. Pierluigi Benedetti Panici
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Corresponding author

Correspondence to Michele Carlo Schiavi.

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Conflict of interest

Author Michele Carlo Schiavi declares that he has no conflict of interest. Author Giorgia Perniola declares that she has no conflict of interest. Author Violante Di Donato declares that he has no conflict of interest. Author Virginia Sibilla Visentin declares that she has no conflict of interest. Author Flaminia Vena declares that she has no conflict of interest. Author Anna Di Pinto declares that she has no conflict of interest. Author Mario Angelo Zullo declares that he has no conflict of interest. Author Marco Monti declares that he has no conflict of interest. Author Pierluigi Benedetti Panici declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Authors’ contributions

All the authors contributed equally to this study. Michele Carlo Schiavi: Project development, Data Collection, Manuscript writing. Giorgia Perniola: Project development, Data Collection, Manuscript writing. Violante Di Donato: Project development, Data Collection, Manuscript writing. Marco Monti: Project development, Data Collection, Manuscript writing. Virginia Sibilla Visentin: Project development, Data Collection, Manuscript writing. Flaminia Vena: Project development, Data Collection, Manuscript writing. Anna Di Pinto: Project development, Data Collection, Manuscript writing. Marzio Angelo Zullo: Project development, Data Collection, Manuscript writing. Pierluigi Benedetti Panici: Project development, Data Collection, Manuscript writing.

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Schiavi, M.C., Perniola, G., Di Donato, V. et al. Severe pelvic organ prolapse treated by vaginal native tissue repair: long-term analysis of outcomes in 146 patients. Arch Gynecol Obstet 295, 917–922 (2017). https://doi.org/10.1007/s00404-017-4307-y

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  • DOI: https://doi.org/10.1007/s00404-017-4307-y

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