PELVIC FLOOR RECONSTRUCTIVE SURGERY. EXPERIENCE OF 119 CASES BETWEEN 2006 AND 2011

Abstract

Objective: To evaluate the experience gained in pelvic floor reconstructive surgery using vaginal mesh between the years 2006 and 2011 at the Hospital Universitario de Caracas, Maternity “Concepcion Palacios”, Policlínica Metropolitana and Instituto Clínico La Florida.
Patients and method: A retrospective study was conducted, based on a population of 119 patients who showed signs of pelvic floor dysfunction, having excluded 13 patients who did not meet the criteria of inclusion. The following variables were studied: age, pelvic organs prolapsed, urinary incontinence, related pathologies, surgical technique, vaginal mesh type, complications and recurrence. A multidisciplinary evaluation was conducted: cystography, transvaginal ultrasound and an uro dynamic study. A conservative or surgical
treatment was indicated, depending on the severity of the prolapse, with a follow up. Results: In a sample of 106 cases, the most frequent diagnosis was cystocele associated with rectocele (63.2%). Urinary incontinency represented 85.5 %. Associated pathology: Uterine fibromatosis (33%). All patients underwent corrective vaginal surgery. Vaginal hysterectomy was predominant (56.6%). Surgical cure of urinary incontinence (85.8%) was conducted. Extrusion was the dominant complication: 11.7%. Conclusion: Surgical treatment of pelvic floor dysfunctions currently represents a challenge for the surgeon and a frequent problem in the women population; the most common
diagnosis include prolapsed pelvic organs (cystocele, rectocele and hysterocele) and urinary incontinence, affecting patients’ quality of life. There are different surgical options using vaginal mesh for the reconstruction of the pelvic floor and the surgical correction of urinary incontinence.