Ponad 7000 publikacji medycznych!
Statystyki za 2021 rok:
odsłony: 8 805 378
Artykuły w Czytelni Medycznej o SARS-CoV-2/Covid-19

Poniżej zamieściliśmy fragment artykułu. Informacja nt. dostępu do pełnej treści artykułu
© Borgis - New Medicine 4/2012, s. 125-128
*Agnieszka Ledniowska1, Grzegorz Ledniowski2, Jarosław Karoń1, Przemysław Karoń1
Implantation of the gynecare prolift system in lower pelvic organ prolapse correction in patients with co-occurring urological disorders
1Gynaecology-Maternity Ward, ZOZ Kędzierzyn-Koźle Public Hospital, Poland
Supervisor: Jarosław Karoń, MD
2Urology Ward, ZOZ Kędzierzyn-Koźle Public Hospital, Poland
Supervisor: Andrzej Trondowski
Aim. Assessment of the impact of correction of pelvic organ prolapse on co-occurring urological disorders in patients operated on with the use of the TVM Prolift system.
Material and methods. The TVM Prolift system was implanted in 22 patients with co-occurring pelvic organ prolapse in POPQ stages from II to IV and urological disorders such as: stress urinary incontinence, mixed urinary incontinence, overactive bladder, pollakiuria and difficulties with starting urination.
Results. In all of the patients, the surgery restored the correct anatomical conditions of the lower pelvic organs. In 77.3% of the patients operated on, the urological problems subsided or abated, in 4.5% of the patients the symptoms intensified and in 18.2% of the patients the symptoms in question remained unchanged.
Conclusions. It is justified to implant the TVM Prolift system in patients with co-occurring pelvic organ prolapse and urological disorders, because after the restoration of proper stability of lower pelvic organs the urological disorders subsided or abated in 77.3% of the patients operated on.

Pelvic organ prolapse (POP) is defined as the descent of lower pelvic organs, which leads to the lowering of the vaginal walls and/or uterus. The final stage of this process is the prolapse of the genital organ. The condition in question can be seen while supine; it usually worsens with the increase of intra-abdominal pressure. This defect often intensifies with consecutive births and the woman’s age (1, 2). According to different authors, the incidence of pelvis organ descent in the female population between 20 and 70 is about 14%. In nulliparous women, POP occurs in 2-4% of the population in multiparous women the incidence of such disorders reaches 76% (3, 4). It is believed that the cause of POP occurrence is the weakening of the pelvic floor muscles, inadequate quality of the connective tissue and failure of the musculo-fibrous apparatus of lower pelvic organs (5).
POP patients often also suffer from urological disorders resulting from abnormal anatomical conditions in the pelvic floor area (6). In order to determine patients in whom genital organ prolapse co-occurs with urological disorders, before any corrective surgeries are conducted, apart from the case history, physical examination and ultrasonographic examination, urodynamic testing needs to be performed.
A number of various POP corrective surgery methods have been developed. It is estimated that the lifetime risk of a surgery due to POP is 7-14% (7). One of the methods of restoration of proper anatomical conditions of lower pelvic organs is vaginal implantation of synthetic meshes (Gynecare Prolift) which take over the role of a deficient suspensory system of lower pelvic organs. The application of synthetic materials significantly improves subsequent results of surgery, thus considerably increasing the comfort of patients’ lives (7). Implantation of the TVM Prolift system enables simultaneous improvement of anatomical conditions of lower pelvic organs as well as resolution of urological disorders in a large number of patients (8).
The evaluation of the results of surgery with the application of the Gynecare Prolift system in instances of urological disorders.
The Gynecare Prolift system was implemented in 22 patients between 33 and 77 in whom pelvic organ prolapse had co-occurred with urological disorders. The patients were operated on at the Kędzierzyn-Koźle ZOZ Public Hospital between October of 2006 and December of 2008.
In the patients, pelvic organ prolapse disorders in stages from II to IV, according to POP-Q classification, co-occurred with urological disorders in the form of: stress urinary incontinence in10 patients, mixed urinary incontinence in 7 patients, in 2 patients overactive bladder was diagnosed, in 2 pollakiuria occurred, 1 patient reported problems with starting urination.
All of the patients were called in for check-ups consisting of physical examination and urodynamic testing. They also filled out anonymous questionnaires, subjectively evaluating their disorders. The patients answered the questions:
1. Did the surgery conducted affect preoperative urological disorders? (a. yes; b. no).
2. If the surgery did affect the disorders, what was the result? (a. resolution of the preoperative symptoms; b. reduction of the preoperative symptoms; c. intensification of the preoperative symptoms).
The application of the TVM Prolift system restored normal anatomical conditions of the genital tract in all of the patients.
Among 22 patients reporting urological problems prior to the surgery, the operation caused:
1. In 15 patients (68.2% of the population) resolution of the symptoms.
2. In 2 patients (9.1% of the population) reduction of the symptoms.
3. In 4 patients (18.2% of the population) the symptoms remained unchanged.
4. In 1 patient (4.5% of the population) the symptoms intensified.

Powyżej zamieściliśmy fragment artykułu, do którego możesz uzyskać pełny dostęp.
Mam kod dostępu
  • Aby uzyskać płatny dostęp do pełnej treści powyższego artykułu albo wszystkich artykułów (w zależności od wybranej opcji), należy wprowadzić kod.
  • Wprowadzając kod, akceptują Państwo treść Regulaminu oraz potwierdzają zapoznanie się z nim.
  • Aby kupić kod proszę skorzystać z jednej z poniższych opcji.

Opcja #1


  • dostęp do tego artykułu
  • dostęp na 7 dni

uzyskany kod musi być wprowadzony na stronie artykułu, do którego został wykupiony

Opcja #2


  • dostęp do tego i pozostałych ponad 7000 artykułów
  • dostęp na 30 dni
  • najpopularniejsza opcja

Opcja #3


  • dostęp do tego i pozostałych ponad 7000 artykułów
  • dostęp na 90 dni
  • oszczędzasz 28 zł
1. Sola V, Pardo J, Ricci P et al.: Tension free monofilament macroporous polypropylene mesh (Gynemesh PS) in female genital prolapse repair. Int Braz J Urol 2006; 32(4): 410-415. 2. Rechberger T, Miotła P, Futyma K et al.: Risk factors of pelvic organ prolapse in women qualified to reconstructive surgery-in Polish multicenter study. Ginekol Pol 2010; 81(11). 3. Swift SE, Tate SB, Nicholas J: Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol 2003; 189(2): 372-377. 4. Tunn R, Petri E: Introital and transvaginal ultrasound as the main tool in the assessment of urogenital and pelvic floor dysfunction: an imaging panel and practical approach. Ultrasound Obstet Gynecol 2003; 22(2): 205-213. 5. DeLancey JO: Anatomy and biomechanics of genital prolapsed. Clin Obstet Gynecol 1993; 36(4): 897-909. 6. Aukee P, Usenius JP, Kirkinen P: An evaluation of pelvic floor anatomy and function by MRI. Eur J Obstet Gynecol Reprod Biol 2004; 112(1): 84-88. 7. Surkont G, Wlaźlak E, Suzin J: Operacyjne leczenie zaburzeń statyki narządu płciowego u kobiet – gdzie jesteśmy, dokąd zmierzamy, Przegląd Urologiczny 2006; 7/4(38). 8. Sergent F, Sentilhes L, Resch B et al.: Treatment of concomitant prolapse and stress urinary incontinence via a transobturator subvesical mesh without independent suburethral tape. Acta Obstet Gynecol Scand 2010; 89(2): 223-229. 9. Bader G, Fauconnier A, Buyot B et al.: Use of prosthetic materials in reconstructive pelvic floor surgery. An evidence-based analysis. Gynecol Obst Fertil 2006; 34(4): 292-297. 10. South M, Amundsen CL: Pelvic organ prolapse: a review of the current literature. Minerva Ginecol 2007; 59(6): 601-612. 11. Br?kken IH, Majida M, Engh ME, Bø K: Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol 2010; 203(2): 170.e1-7. 12. Hagen S, Stark D, Glazener C et al.: A randomized controlled trial of pelvic floor muscle training for stages I and II pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20(1): 45-51. 13. Patel M, Mellen C, O’Sullivan DM et al.: Impact of pessary use on prolapse symptoms, quality of life, and body image. Am J Obstet Gynecol 2010; 202(5): 499.e1-4. 14. Maher C, Feiner B, Baessler K et al.: Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 2010; 14, 4: CD004014. 15. 15. Yuan Z, Dai Y, Cen Y: Clinical study on concomitant surgery for stress urinary incontinence and pelvic organ prolapsed. Zhonghua Wai Ke Za Hi 2008; 46(20): 1533-1535. 16. Sergent F, Sentilhes L, Resch B et al.: Treatment of concomitant prolapse and stress urinary incontinence via a transobturator subvesical mesh without independent suburethral tape. Acta Obstet Gynecol Scand 2010; 89(2): 223-229. 17. Shek KL, Rane A, Goh J et al.: Stress urinary incontinence after transobturator mesh for cystocele repair. Int Urogynecol J Pelvic Floor Dysfunct 2009; 20(4): 421-425. 18. De Boer TA, Kluivers KB, Withagen MI et al.: Predictive factors for overactive bladder symptoms after pelvic organ prolapse surgery. Int Urogynecol J Pelvic Floor Dysfunct 2010; 21(9): 1143-1149. 19. Long CY, Hsu CS, Wu MP et al.: Predictors of improved overactive bladder symptoms after transvaginal mesh repair for the treatment of pelvic organ prolapse: Predictors of Improved OAB after POP Repair. Int Urogynecol J 2010; 22(5): 535-642. 20. Ek M, Altman D, Falconer C et al.: Effects of anterior trocar guided transvaginal mesh surgery on lower urinary tract symptoms. Neurourol Urodyn 2010; 29(8): 1419-1423.
otrzymano: 2012-11-13
zaakceptowano do druku: 2012-11-30

Adres do korespondencji:
*Agnieszka Ledniowska
Gynaecology-Maternity Ward ZOZ Kędzierzyn-Koźle Public Hospital
24 Kwietnia St. 5, 47-200 Kędzierzyn-Koźle
tel.: +48 517-056-831
e-mail: a.ledniowska@interia.pl

New Medicine 4/2012
Strona internetowa czasopisma New Medicine