General Gynecology and Pelvic Floor
Zinat Ghanbari; Leila Pourali; Tahereh Eftekhar; Maryam Deldar Pesikhani; Soudabeh Darvish; Zahra Lotfi; Elnaz Ayati
Volume 9, Issue 2 , March and April 2024, , Pages 144-149
Abstract
Background & Objective: Defecatory dysfunction is a common problem among women who are referred for urogynecological care. Pelvic organs prolapse (POP) which is a downward displacement of pelvic organs is one of the common conditions among patients with defecatory problems. This study was planned ...
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Background & Objective: Defecatory dysfunction is a common problem among women who are referred for urogynecological care. Pelvic organs prolapse (POP) which is a downward displacement of pelvic organs is one of the common conditions among patients with defecatory problems. This study was planned to evaluate the correlation of obstructive defecatory symptoms with the site and severity of pelvic organ prolapse and the anorectal manometry results.Materials & Methods: This cross-sectional study was performed between Dec 2018 and Nov 2019. A total of 150 women with symptoms of defecatory problems were enrolled. Patients were classified in two groups according to each compartment prolapse staging and severity: stage ≤2 and stage >2. The correlation between defecatory symptoms and pelvic organ prolapse examination, anorectal examination and anal manometry were evaluated.Results: A total of 150 women were evaluated. There was a significant correlation between higher stage of anterior compartment prolapse (cystocele stage>2) and constipation (P=0.035). Although all the defecatory symptoms were more frequent in anterior prolapse stage>2, but the difference was not significant (P>0.05). There was no significant correlation between defecatory symptoms and severity of posterior compartment prolapse. There was a significant correlation between stage>2 of apical prolapse and all the defecatory symptoms (P≤0.05). The abnormal anal resting and squeeze pressure and abnormal balloon expulsion test were more frequent in stage >2 of all compartments prolapse, but the difference was not significant (P>0.05).Conclusion: Obstructed defecation syndrome was more frequent in patients with higher stages of anterior and apical prolapse. Abnormal manometry results were more frequent in patients with defecatory dysfunction with advanced vaginal prolapse.
General Gynecology and Pelvic Floor
Zinat Ghanbari; Leila Pourali; Tahereh Eftekhar; Maryam Deldar Pesikhani; Soudabeh Darvish; Elnaz Ayati; Zahra Lotfi
Volume 8, Issue 5 , September and October 2023, , Pages 431-437
Abstract
Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could ...
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Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could negatively affect the quality of life in these patients. This study aimed to assess the surgical outcomes of native-tissue apical suspension by sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS).Materials & Methods: This prospective cohort study was conducted to evaluate the outcomes of native-tissue apical suspension for pelvic organ prolapse within one year after the surgery from March 2017 to July 2019 at Imam Khomeini hospital, an academic hospital of Tehran University of Medical Sciences, Tehran, Iran. Inclusion criteria were patients with uterine prolapse at Stage 2 or 3 according to the Pelvic Organ Prolapse Quantification System (POP–Q) who planned for total vaginal hysterectomy and apical suspension using uterosacral ligament suspension (ULS) or sacrospinous ligament fixation (SSLF) with no history of pelvic organ prolapse surgery. The main outcome was surgical consequences within 1 year after surgery.Results: There was no significant difference between the two groups in terms of relapse of anterior, posterior, or apical compartment prolapse. According to the clinical recurrence, although vaginal bulging and pressure were more common in sacrospinous ligament fixation (SSLF) group, the difference was not significant. The number of patients with severe buttock and pelvic pain was significantly higher in the sacrospinous ligament fixation (SSLF) group.Conclusion: sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are both optimal procedures with the same complications and similar surgical outcomes; however, uterosacral ligament suspension (ULS) had lower post-operative pelvic pain, and also the number of retreatment was lower in this group.