Abstract
The objective of this study was to determine if obliterative and reconstructive vaginal surgery for advanced pelvic organ prolapse improve quality of life in elderly women. Women age 65 years or older with stage 3 or 4 pelvic organ prolapse who desired surgical correction were prospectively enrolled. The subjects underwent either obliterative or reconstructive vaginal surgery based on their personal preference and sexual expectations. The subjects received a pelvic organ prolapse quantitation examination and completed the pelvic floor distress inventory (PFDI), the pelvic floor impact questionnaire (PFIQ), the SF-36, and the Beck depression inventory preoperatively, 6 and 12 months after surgery. Seventy-nine subjects were enrolled, 70 of whom completed follow-up: 30 in the obliterative group and 40 in the reconstructive group. Both groups demonstrated significant improvements in the pelvic organ prolapse, urinary, and colorectal scales of the PFDI and PFIQ 6 and 12 months after surgery with no differences between the two treatment groups. In addition, there were significant and clinically important improvements noted in the bodily pain, vitality, social functioning, role–emotional, and mental health summary scales of the SF-36 in both groups after surgery, with no significant difference between groups. In appropriately selected elderly women, both obliterative and reconstructive vaginal surgery for advanced pelvic organ prolapse significantly improved health-related quality of life.
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References
Olsen AL, Smith VJ, Bergstom JO et al (2001) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506
Denehey TR, Choe JY, Gregori CA, Breen JL (1995) Modified Le Fort partial colpocleisis with Kelly urethral plication and posterior colpoperineoplasty in the medically compromised elderly: a comparison with vaginal hysterectomy, anterior colporrhaphy and posterior colpoperineoplasty. Am J Obstet Gynecol 173:1697–1702
Nichols DH, Randall CL (1996) Vaginal surgery, 4th edn. Williams and Wilkins, Baltimore, pp 359–360
Cundiff GW, Addison WA (1998) Management of pelvic organ prolapse. Obstet Gynecol Clin North Am 25:907–921
FitzGerald MP, Richter HE, Siddique S, Thomson P, Zyczynski H, Weber A (2006) Colpocleisis: a review. Int Urogynecol J 17(3):261–271
DeLancey JO, Morley GW (1997) Total colpocleisis for vaginal eversion. Am J Obstet Gynecol 176:1228–1235
Hanson, GE, Keettel WC (1969) The Neugebauer–LeFort operation: a review of 288 colpocleisis. Obstet Gynecol 34:352–357
Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17
Charlson ME, Pompei P, Aless KL, MacKenzie Cr (1987) A new method of classifying prognostic comorbity in longitudinal studies: development and validation. J Chronic Dis 40:373–383
Hlatky MA, Boineau RE, Higginbotham MB, Lee KL, Mark DB, Califf RM, Cobb FR, Pryor DB (1989) A brief self-administered questionnaire to determine functional capacity (Duke activity status index). Am J Cardiol 64:651–654
Barber MD, Kuchibhatla MN, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395
Ware JE (1993) SF-36 Heath survey: manual and interpretation guide. Health Institute, New England Medical Center, Boston
Richter P, Werner J, Heerlein A et al (1998) On the validity of the Beck depression inventory: a review. Psychopathology 31:160–168
Weber AM, Abrams P, Brubaker L, Cundiff G, Davis G, Dmochowski RR, Fischer J, Hull T, Nygaard I, Weidner AC (2001) The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J 12:178–186
Hopwood P, Fletcher I, Lee A, Al Ghazal S (2001) A body image scale for use with cancer patients. Eur J Cancer 37:189–197
Garry R, Fountain J, Mason S, Hawe J, Napp V, Abbot J et al (2004) The eVALuate study: two parallel randomized trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ 328:129–133
Jelovsek J, Barber M (2006) Advanced pelvic organ prolapse decreases body image and quality of life. Am J Obstet Gynecol 194:1455–1461
Barber MD, Walters MD, Cundiff GW, the PESSRI Trial Group (2006) Responsiveness of the pelvic floor distress inventory and pelvic floor impact questionnaire in women undergoing surgical and non-surgical treatment for pelvic organ prolapse. Am J Obstet Gynecol 194:1492–1498
von Pechmann WS, Mutone M, Fyffe J, Hale DS (2003) Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol 189:121–126
Ubachs JM, van Sante TJ, Schellekens LA (1972) Partial colpocleisis by a modification of Le Fort’s operation. Obstet Gynecol 42:415–420
Harmanli OH, Dandolu V, Chatwani AJ, Grody MHT (2003) Total colpocleisis for severe pelvic organ prolapse. J Reprod Med 48:703–706
Patel D, Gillespie B, Foxman B (2003) Sexual behavior of older women: results of a random digit-dialing survey of 2000 women in the United States. Sex Transm Dis 30:216–220
Heit M, Culligan P, Rosenquist C, Shott S (2002) Is pelvic organ prolapse a cause of pelvic or low back pain? Obstet Gynecol 99:23–28
Swift SE, Tate SB, Nicholas J (2003) Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse. Am J Obstet Gynecol 189:372–379
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Barber, M.D., Amundsen, C.L., Paraiso, M.F.R. et al. Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery. Int Urogynecol J 18, 799–806 (2007). https://doi.org/10.1007/s00192-006-0240-5
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DOI: https://doi.org/10.1007/s00192-006-0240-5