Clinical Study

A new, non-compensatory colpopexy technique for stage IV POP: Long-term clinical outcomes

  • Adam Ostrzenski

Received Date: 24.05.2006 Accepted Date: 22.08.2006 J Turk Ger Gynecol Assoc 2006;7(3):215-223

OBJECTIVE

To analyze and report results of long-term clinical outcomes of non-compensatory colpopexy in women associated with stage IV POP.

Study Designed

This was a prospective comparative cohort study of 27 women with stage IV POP. The control group I included 16 women and the interventional group II included 11 subjects. In group I, 3 anatomical levels and in group II 4 anatomical levels of pelvic defects were repaired. No other concomitant surgery was performed. Postoperatively, all subjects were followed-up annually from February 1996 to February 2006. The POP-Q classification and the UDI were utilized for evaluation. The primary outcome measure was POP recurrence and secondary outcome measure was to determine occurrence of urinary incontinence, dyspareunia, changes in libido and changes in frequency of coital events. Statistical analysis was performed with an x2 test, a Student t test, and 2-sided Fisher test.

RESULTS

Preoperatively in both groups, subjects reported the presence of superficial and/or deep dyspareunia, decreased libido and low number coital events (≤ 1 coital event per months). The group I had statistically significant higher POP recurrence (P =.004), one case of mixed urinary incontinence; overall improvement of dyspareunia, libido and the frequency of coital events were documented. In the group II, the cured rate of POP was 91 % (P =.004) and 9% recurrent stage III POP was noted; no urinary incontinence had occurred; dyspareunia was cured in all cases and libido, and the number of coital events improved significantly (P =. 001).

CONCLUSIONS

1.In the interventional group, the cure rate was statistically significant higher and no urinary incontinence occurred, dyspareunia, libido, and the number of coital events improved significantly. 2. Reconstructing all defects in all four anatomical levels provided optimal outcomes of the surgery.

Keywords: Colpopexy, Colposuspension, Pelvic organ prolapse; Laparoscopic surgery