The Vaginal Patch Plastron Associated to the Anterior Sacrospinous Ligament Fixation for the Treatment of Advanced Anterior Vaginal Wall Prolapse. - 2022
anterior sacrospinous ligament fixation; autologous tissue; cystocele; pelvic organ prolapse; plastron; vaginal patch plastron; Medicine (all)
Abstract :
[en] Background: this study aims to compare the efficacy and safety of vaginal patch plastron (VPP) associated to anterior sacrospinous ligament fixation (SSLF-A) with SSLF-A associated or not to the anterior colporrhaphy (AC) for cystocele treatment. Methods: single-center retrospective study in women with cystocele ≥ III stage submitted to surgery. The primary outcome was to compare objective and subjective cystocele relapse and reoperation rate at follow-up > 6 months. The secondary outcome was to describe peri- and postoperative complications and risk factors for cystocele objective relapse. Results: 75 women were submitted to SSLF-A and 61 women to VPP. VPP objective and subjective relapse (6.5%, 4/61 and 1.1%, 1/61) were lower than SSLF-A (26.7%, 20/75 and 20%, 15/75; p = 0.002 and p = 0.001, respectively). SSLF-A had a higher reintervention rate, but not significantly (6.6%, 5/75 vs. 0%, 0/61; p = 0.06). Previous hysterectomy was a risk factor (HR 4; 1.3−12.1) while VPP was protective factor (HR 0.2; 0.1−0.9) for cystocele anatomical relapse. Postoperative buttock pain was more prevalent in VPP (57.4%, 35/75 vs. 34.7%, 26/61; p = 0.01). Conclusions: VPP is effective and safe for advanced cystocele treatment, with lower objective and subjective relapse rates in comparison to isolated SSLF-A or associated with the AC.
Disciplines :
Surgery
Author, co-author :
Ruffolo, Alessandro Ferdinando ; Department of Gynecology, Jeanne de Flandre University Hospital, 59000 Lille, France ; Unit of Gynecology and Obstetrics, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
Lambert, Benjamin ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Department of Gynecology, Jeanne de Flandre University Hospital, 59000 Lille, France
Lallemant, Marine ; Department of Gynecology, University Hospital of Besançon, 25000 Besançon, France
Candiani, Massimo; Unit of Gynecology and Obstetrics, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
Salvatore, Stefano; Unit of Gynecology and Obstetrics, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
Cosson, Michel; Department of Gynecology, Jeanne de Flandre University Hospital, 59000 Lille, France
Language :
English
Title :
The Vaginal Patch Plastron Associated to the Anterior Sacrospinous Ligament Fixation for the Treatment of Advanced Anterior Vaginal Wall Prolapse.
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