Vaginal extirpation of the uterus using implants made of titanium silk to prevent recurrence of the disease

Cover Page

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

INTRODUCTION: The frequency of post-hysterectomy prolapse of the vaginal dome reaches 43% in patients after surgical treatment for complete uterine prolapse. Goal ― improving the effectiveness of surgical treatment with titanium mesh implants in pre- and postmenopausal patients with complete uterine prolapse.

MATERIALS AND METHODS: The study involved 21 patients with complete uterine prolapse who underwent the proposed new method of transvaginal surgical prevention of post-hysterectomy prolapse of the vaginal dome. The result of surgical treatment was evaluated by analyzing the data of vaginal examination and ultrasound.

RESULTS: Patients were observed for 2 years ― after 1, 6, 12 and 24 months. Analysis of vaginal examination and ultrasound data showed no displacement of the vaginal dome, pelvic organs and deformation of titanium implants. There were no mesh-associated complications during follow-up.

CONCLUSIONS: The use of the developed surgical method for the correction of post-hysterectomy prolapse of the vaginal dome with the use of implants made of titanium silk is a reliable tool that provides anatomical efficiency in pre- and postmenopausal patients.

Full Text

Restricted Access

About the authors

Anatoliy I. Ishchenko

I.M. Sechenov First Moscow State Medical University; V.F. Snegirev Clinic of Obstetrics and Gynecology

Email: 7205502@mail.ru
ORCID iD: 0000-0003-3338-1113

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow; Moscow

Tat'yana V. Gavrilova

V.F. Snegirev Clinic of Obstetrics and Gynecology

Author for correspondence.
Email: gavrilova.tw2010@yandex.ru

obstetrician-gynecologist

Russian Federation, Moscow

Anton A. Ishchenko

I.M. Sechenov First Moscow State Medical University

Email: ra2001_2001@mail.ru
ORCID iD: 0000-0001-6673-3934
SPIN-code: 2306-4571

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Oksana Y. Gorbenko

I.M. Sechenov First Moscow State Medical University

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

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Teya A. Dzhibladze

I.M. Sechenov First Moscow State Medical University

Email: djiba@bk.ru
ORCID iD: 0000-0003-1540-5628

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Irina D. Khokhlova

I.M. Sechenov First Moscow State Medical University

Email: irhohlova5@gmail.com
ORCID iD: 0000-0001-8547-6750

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Leonid S. Aleksandrov

I.M. Sechenov First Moscow State Medical University

Email: leonid.aleks@bk.ru
ORCID iD: 0000-0002-7601-3532

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

References

  1. Kulakov VI, Adamyan LV, Askol’skaya SI. Women’s health and hysterectomy. In: Materials of the International Congress «Endoskopiya v diagnostike, lechenii i monitoringe zhenskikh boleznei». Moscow: Santori; 2000. P. 224–237. (In Russ).
  2. Baggish MS, Karram MM. Atlas of pelvic Anatomy and Gynecologic Surgery. 4th ed. Eng: Elsevier; 2015. 1408 p.
  3. Luk’yanova DM, Smol’nova TYu, Adamyan LV. Modern molecular-genetic and biochemical predictors of genital prolapsed. Problemy reproduktsii. 2016;(4):8. (In Russ).
  4. Bezhenar’ VF, Bogatyreva EV. Methods of surgical treatment of rectocele in women with omission and prolapse of the internal genitals. Zhurnal akusherstva i zhenskikh boleznei. 2009;LVIII(2):16–22. (In Russ).
  5. Malkhasyan VA, Kasyan GR, Sumerova NM. Anatomical and functional results of surgical correction of pelvic organ prolapse using transvaginal implantation of a synthetic prosthesis: a prospective study in 105 patients. Rossiiskii vestnik akushera-ginekologa. 2012;1:70–74. (In Russ).
  6. Hirsch HA, Kezer O, Ikle FA. Operative gynecology. Atlas. Transl. from English. Мoscow: GEOTAR-media; 2004. 649 p. (In Russ).
  7. Frinovskii VS. Mayo surgery for uterine prolapse in elderly women and its long-term results. Akusherstvo i ginekologiya.1941;(5):32–35. (In Russ).
  8. Shalaev ON. Khirurgicheskoe lechenie dobrokachestvennykh zabolevanii matki i genital’nogo prolapsa s ispol’zovaniem vlagalishchnogo operativnogo dostupa [dissertation]. Moscow; 2004. Available from: https://elibrary.ru/item.asp?id=16170836. (In Russ).
  9. Patel H, Ostergard DR, Sternschuss G. Polypropylene mesh and the host response. Int Urologynecol J. 2012;23(6):669–679.
  10. Popov AA. Sovremennye aspekty diagnostiki, klassifikatsii i khirurgicheskogo lecheniya opushcheniya i vypadeniya zhenskikh polovykh organov [dissertation]. Moscow; 2001. Available from: https://rusneb.ru/catalog/000200_000018_RU_NLR_bibl_408447/. (In Russ).
  11. Popov AA, Kashina EA, Buyanova SN, et al. Surgical treatment of patients with omission and prolapse of the internal genitals and prevention of omission of the vaginal dome after hysterectomy. Rossiiskii vestnik akushera-ginekologa. 2006;6(4):66–71. (In Russ).
  12. Tikhomirov AL, Bagaev VM, Khodzhaev GG. Treatment of omission and prolapse of the vagina and uterus. In: Collection of scientific works of employees of the Central Clinical Hospital of the Ministry of Railways. Moscow. 1999;(4):502–510. (In Russ).
  13. Malinowski A, Pawlowski T, Maciolek-Blew-Nielwska G, Augustyniak T. Sacrospinous ligament vaginal vault fixation-method, results and a one-year follow up in 10 patients. Ginekol Pol. 2004;75(9):713–719.
  14. Fatton B, Dwyer PL, Achtari C, Tan PK. Bilateral extraperitoneal uterosacral vaginae vault suspension: a 2-year follow-up lougitudinal case series of 123 patients. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(4):427–434. doi: 10.1007/s00192-008-0791-8
  15. Chechneva MA, Barto RA, Burykina TS, Krasnopol’skaya IV, Obramyat KN. Modern ideas about the pathogenesis, diagnosis and methods of correction of genital prolapse and its complications (literature review). Patogenez. 2014;12(4):4–9. (In Russ).
  16. Abed H, Rahn DD, Lowenstein L, et al. Incidence and management of graft erosion, wound granulation, and dyspareunia following vaginal prolapse repair with graft materials: a systematic review. Int Urogynecol J. 2011;22(7):789–798.
  17. Вlandon RE, Gebhart JB, Trabuco EC, Klingele CJ. Complication from vaginally placed mesh in pelvic reconstructive surgery. Int Urologynecol J. 2009;20(5):523–531.
  18. Dandolu V, Akiyama M. Mesh complications and failure rates after transvaginal mesh repair compared with abdominal or laparoscopic sacrocolpopexy and to native tissue repair in treating apical prolapsed. Int Urogynecol J. 2017;28(2):215–222.
  19. Sung VW, Rogers RG, Schaffer JI, et al. Graft use in transvaginal pelvic organ prolapse repair: a systematic review. Obstet Gynecol. 2008;112(5):1131–1142.
  20. Baggish MS, Karram MM. Atlas of Pelvic Anatomy and Gynecologic Surgery. 4th ed. Eng: Elsevier; 2015. 1408 p.
  21. Khodakov VV, Zabrodin VV, Zabrodin EV, Vaseva ON. Immediate and long-term results of surgical treatment of inguinal hernias using mesh titanium endoprostheses. Meditsinskii zhurnal. 2018;(7):93–101. doi: 10.25694/URMJ.2018.04.132. (In Russ).

Supplementary files

Supplementary Files
Action
1. Fig. Fixation of mesh titanium implants to a ligamentous monoblock (sacro-utero-cardinal complex).

Download (161KB)

Statistics

Views

Abstract: 136

PDF (Russian): 1

Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2021 Eco-Vector



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies