Surgical correction of prolapse of anterior wall of the vagina and cervix using titanium mesh implants

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Abstract


Background: Regardless of a variety of surgical techniques and hi-tech materials for pelvic prolapse treatment, there is no decrease in the disease recurrences.

Aims: Evaluation of the efficacy of the developed method of surgical correction of II–IV degree colpoptosis anterior combined with II–III degree “C”-prolapse with the use of titanium mesh implants in reproductive, pre- and postmenopausal female patients.

Methods: Female patients (group I, n = 25) with colpoptosis anterior and cervical prolapse were examined and operated on according to the developed know-how technique with the use of titanium mesh implants. Evaluation of the efficacy of surgical correction of the disease was performed using questioning, pelvic exam with Valsalva manoeuvre, transvaginal and transperineal ultrasound, pelvis MRI. The findings were compared with the result of surgical treatment of 46 (group II) and 32 (group III) female patients operated on without the use of titanium implants. After surgical treatment according to the three-stage surgical program that provides for multifocal fixation of anatomical formations with the use of titanium implants, the case follow-up was performed in 3−21 months.

Results: Questioning the patients in group I demonstrated their satisfaction with the surgical treatment results that positively affected the quality of life, mood, and contributed to an increase in sexual activity and community commitment. Check-up showed that the surgical correction of prolapse was completely preserved in the patients of group I during 18−21 months. Pelvic exam at rest and with Valsalva manoeuvre, transvaginal and transperineal ultrasound, pelvis MRI did not reveal any significant extrusion of the pelvic organs or titanium implants. No mesh-associated complications were observed during the follow-up. Recurrence of genital prolapse was diagnosed in 12 (26%) patients of group II, mesh-associated complications were detected in 6 (18.8%) women of group III.

Conclusions: The preserving three-stage surgical program, developed by us, contributed to optimize the results of surgical treatment, decrease the rate of the disease recurrence, and reduce the risk of the development of mesh-associated complications.


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About the authors

Anatoly I. Ishchenko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: 7205502@mail.ru
ORCID iD: 0000-0001-5733-953X
SPIN-code: 3294-3251

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, PhD, Professor

Leonid S. Aleksandrov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: aleksandrov.leonid@lenta.ru
ORCID iD: 0000-0002-7601-3532
SPIN-code: 2738-9662

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, PhD, Professor

Anton A. Ishchenko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: ra2001_2001@mail.ru
ORCID iD: 0000-0002-4476-4972
SPIN-code: 2306-4571

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

PhD

Anton A. Kazantsev

Central Clinical Hospital of the Russian Academy of Sciences

Email: kaa7171@mail.ru
ORCID iD: 0000-0001-7922-2033
SPIN-code: 3674-2553

Russian Federation, 1A, Litovskiy blvrd., Moscow, 117593

Irina D. Khokhlova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: irhohlova5@gmail.com
ORCID iD: 0000-0001-8547-6750
SPIN-code: 6858-5235

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

PhD

Tea A. Dzhibladze

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: djiba@bk.ru
ORCID iD: 0000-0003-1540-5628
SPIN-code: 5688-1084

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, PhD, Professor

Oksana Yu. Gorbenko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: go2601@mail.ru
ORCID iD: 0000-0002-3435-4590
SPIN-code: 8725-1419

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

PhD

Yuriy V. Chuschkov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: obstetrics-gynecology@list.ru
SPIN-code: 6066-9279

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

PhD

Vladimir M. Zuev

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: vlzuev@bk.ru
ORCID iD: 0000-0001-8715-2020
SPIN-code: 8725-1419

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, PhD, Professor

Yuliya B. Manevskaya

Treatment and rehabilitation center

Email: manevskaia@gmail.com
ORCID iD: 0000-0002-1799-2777
SPIN-code: 1033-6160

Russian Federation, Moscow

Anastasiya D. Uschkova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: ushkova669@yandex.ru
SPIN-code: 3908-0297

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

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Supplementary files

Supplementary Files Action
1.
Fig. 1. Surface relief on a titanium mesh endoprosthesis

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