Remote outcomes of treating patients with early forms of pelvic prolapse
The objective. Assessment of remote outcomes of various kinds of treatment in patients with early forms of pelvic prolapse. Patients and methods. We examined 240 women aged 28 to 42 years with pelvic prolapse (PP) stage 1-2 according to POP-Q assessment. Two groups of patients were singled out. Patients of group 1 (140) underwent surgical treatment (colpoperineorrhaphy, perineal levatorplasty), patients of group 2 (100) received conservative treatment that included instrumental therapies and home exercises. Remote outcomes of surgical and conservative treatments were assessed 5 years after treatment and included analysis of the patients' complaints and recovery of normal anatomical correlations at clinical examination, functional tests and echography. Results. A positive effect (lower stage of prolapse) was noted in 128 (91.4%) patients of the operative treatment group, and progression of prolapse - only in 1.5% of cases. Stabilisation of the process was found in 7.1% of the examined patients. In group 2, a positive effect was noted only in 4 patients (4%), and almost in every second patient prolapse progressed to more severe stages. Conclusion. Conservative treatment of patients has little effect, and in every third patient diseases progresses to more severe forms. Surgical treatment of early forms of PP is pathogenetically justified and highly effective, since it promotes recovery of the normal anatomy of the pelvic floor.
1 Department of Obstetrics, Gynaecology and Reproductive Medicine, Faculty of Post-graduate Education, People's Friendship University of Russia, 8, ul. Miklukho-Maklaya, Moscow, 117198, Russian Federation
Early forms; Pelvic prolapse; Remote outcomes; Surgical treatment