Different Surgical Techniques Used for Prolapse Repair in Elderly Patient
Condition: Unrecognized Condition
MeSH terms: Prolapse
Study type: Observational

Summary: 
      The investigator aimed to compare various pelvic floor repairs in female aged from 70 to 80
      years old, to see which procedure in terms of treatment-related complications of SCP, VMR and
      NTR by comparing the operative and functional outcomes in this patient population.
    

Detailed description: 
      Pelvic organ prolapse (POP) is a global health care issue that could have a significant
      impact on pelvic floor function and quality of life (QOL), while seldom having the potential
      to be life-threatening. Prevalence of POP increases with age. In women older than 80, 11%
      undergo a surgical procedure. The incidence of degenerative diseases and multiple
      co-morbidities increases with age, and advanced age is also associated with an increase in
      morbidity generally for gynecologic procedures. Furthermore, greater comorbidity beforehand
      can predispose patients to postoperative complications such as bleeding, hematoma, pain,
      infectious. As a result hospital stays are longer and the surgical results are compromised.

      Surgical techniques should optimize functional results and minimize complications. In POP
      surgery, younger women are good candidates for sacrocolpopexy (SCP), because of the improved
      long term functional result, while women older than 80 may have a satisfactory outcome with
      fewer complication with a vaginal repair with mesh (VMR) or native tissue (NTR). The
      increasing prevalence of POP, and the increasing population of women aged 70-80 requires an
      evaluation of the appropriate surgical management since women in this age group may be
      candidates for all types of surgical repair.
    

Intervention name(s): SCP; NTR; VMR
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Sacrocolpopexy (SCP) aims to secure the anterior vaginal wall, the uterus more or less the posterior vaginal wall using polypropylene prostheses and to secure them to the presacral ligament to restore the patient's anatomical features and improve pelvic symptoms; Native tissue repair surgery (NTR) consist of site-specific surgical repair of the existing defect (anterior and/or posterior) using non-absorbable sutures. Specifically, anterior and/or posterior colporrhaphy for cystocele and rectocele respectively after adequate hydrodissection of the vesicovaginal or rectovaginal space.; Vaginal mesh repair surgery (VMR) is performed using a single-incision mesh system. A single vertical incision is made in the anterior and/or posterior vaginal wall. A full-thickness dissection is performed laterally and apically to the ischial spine.
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        The study cohort is selected from our institution. The study involves elderly females over
        70 years old with advanced pelvic organ prolapse.
      
Keywords: Elderly; Native tissue repair; Pelvic Organ Prolapse; Sacrocolpopexy; Vaginal mesh repair