General Gynecology and Pelvic Floor
Zinat Ghanbari; Leila Pourali; Tahereh Eftekhar; Maryam Deldar Pesikhani; Soudabeh Darvish; Zahra Lotfi; Elnaz Ayati
Volume 9, Issue 2 , March and April 2024, , Pages 144-149
Abstract
Background & Objective: Defecatory dysfunction is a common problem among women who are referred for urogynecological care. Pelvic organs prolapse (POP) which is a downward displacement of pelvic organs is one of the common conditions among patients with defecatory problems. This study was planned ...
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Background & Objective: Defecatory dysfunction is a common problem among women who are referred for urogynecological care. Pelvic organs prolapse (POP) which is a downward displacement of pelvic organs is one of the common conditions among patients with defecatory problems. This study was planned to evaluate the correlation of obstructive defecatory symptoms with the site and severity of pelvic organ prolapse and the anorectal manometry results.
Materials & Methods: This cross-sectional study was performed between Dec 2018 and Nov 2019. A total of 150 women with symptoms of defecatory problems were enrolled. Patients were classified in two groups according to each compartment prolapse staging and severity: stage ≤2 and stage >2. The correlation between defecatory symptoms and pelvic organ prolapse examination, anorectal examination and anal manometry were evaluated.
Results: A total of 150 women were evaluated. There was a significant correlation between higher stage of anterior compartment prolapse (cystocele stage>2) and constipation (P=0.035). Although all the defecatory symptoms were more frequent in anterior prolapse stage>2, but the difference was not significant (P>0.05). There was no significant correlation between defecatory symptoms and severity of posterior compartment prolapse. There was a significant correlation between stage>2 of apical prolapse and all the defecatory symptoms (P≤0.05). The abnormal anal resting and squeeze pressure and abnormal balloon expulsion test were more frequent in stage >2 of all compartments prolapse, but the difference was not significant (P>0.05).
Conclusion: Obstructed defecation syndrome was more frequent in patients with higher stages of anterior and apical prolapse. Abnormal manometry results were more frequent in patients with defecatory dysfunction with advanced vaginal prolapse.
General Gynecology and Pelvic Floor
Zinat Ghanbari; Leila Pourali; Tahereh Eftekhar; Maryam Deldar Pesikhani; Soudabeh Darvish; Elnaz Ayati; Zahra Lotfi
Volume 8, Issue 5 , September and October 2023, , Pages 431-437
Abstract
Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could ...
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Background & Objective: Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could negatively affect the quality of life in these patients. This study aimed to assess the surgical outcomes of native-tissue apical suspension by sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS).Materials & Methods: This prospective cohort study was conducted to evaluate the outcomes of native-tissue apical suspension for pelvic organ prolapse within one year after the surgery from March 2017 to July 2019 at Imam Khomeini hospital, an academic hospital of Tehran University of Medical Sciences, Tehran, Iran. Inclusion criteria were patients with uterine prolapse at Stage 2 or 3 according to the Pelvic Organ Prolapse Quantification System (POP–Q) who planned for total vaginal hysterectomy and apical suspension using uterosacral ligament suspension (ULS) or sacrospinous ligament fixation (SSLF) with no history of pelvic organ prolapse surgery. The main outcome was surgical consequences within 1 year after surgery.Results: There was no significant difference between the two groups in terms of relapse of anterior, posterior, or apical compartment prolapse. According to the clinical recurrence, although vaginal bulging and pressure were more common in sacrospinous ligament fixation (SSLF) group, the difference was not significant. The number of patients with severe buttock and pelvic pain was significantly higher in the sacrospinous ligament fixation (SSLF) group.Conclusion: sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are both optimal procedures with the same complications and similar surgical outcomes; however, uterosacral ligament suspension (ULS) had lower post-operative pelvic pain, and also the number of retreatment was lower in this group.
General Gynecology and Pelvic Floor
Zinat Ghanbari; Maryam Deldar Pesikhani; Parivash Jelodarian; Reihane Sadat Hosseini
Volume 8, Issue 5 , September and October 2023, , Pages 528-532
Abstract
Postoperative abscess after colpocleisis is rare. We reported a 67-year-old woman with an abscess after a month of Le Fort colpocleisis. Two abscesses of approximately 5 cm in size were drained. The injection of antibiotics continued up to 7 days after the surgery, and the drain was taken on the 4th ...
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Postoperative abscess after colpocleisis is rare. We reported a 67-year-old woman with an abscess after a month of Le Fort colpocleisis. Two abscesses of approximately 5 cm in size were drained. The injection of antibiotics continued up to 7 days after the surgery, and the drain was taken on the 4th day after the operation due to the improvement of the patient's general conditions and no discharge. It is recommended to consider pelvic abscess in patients suffering from fever, pain, pelvic pressure, and diarrhea after pelvic surgeries. Early diagnosis and treatment will reduce mortality and disability in patients.
General Gynecology and Pelvic Floor
Parvin Bastani; Malahat Ebrahimpour; Fatemeh Mallah; Sakineh Hajebrahimi; Hanieh Salehi Pourmehr
Volume 7, Issue 2 , September and October 2021, , Pages 105-113
Abstract
Background & Objective: Pelvic organ prolapse (POP) is accompanied by a remarkable decline in the quality of life. Determining the best surgical approach for women with POP is difficult because of outcome variations. We compared the outcomes of pelvic organ prolapse (POP) treatment by abdominal sacrocolpopexy ...
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Background & Objective: Pelvic organ prolapse (POP) is accompanied by a remarkable decline in the quality of life. Determining the best surgical approach for women with POP is difficult because of outcome variations. We compared the outcomes of pelvic organ prolapse (POP) treatment by abdominal sacrocolpopexy (ASC) and vaginal sacrospinous ligament suspension (SSLS) for advanced apical prolapse beyond the level of the hymen (stage≥ II). Materials & Methods: This retrospective study was conducted on a case series of 58 ASC and 48 SSLS surgeries, which were performed through the posterior approach for advance prolapse during January 2019-April 2020. Pelvic Floor Disability Index (PFDI-20) questionnaire was completed both at the first visit and a year postop. All patients were visited ten days after the procedure and re-visited after 2, 4, 6, and 12 months.Results: Of a total of 106 women, 80 cases completed the study (n=40 in each group). Within-group analysis showed that the overall score of PFDI-20 and its subscales decreased in both evaluated groups after surgery (P < /em><0.001). However, the between-group analysis revealed that this reduction in the ASC group was statistically significant in the total score of PFDI, POPDI-6, and UDI-6 subscales (P < /em><0.05). In addition, vaginal length was demonstrated to improve in both groups, which was statistically significant in the ASC group (P < /em>=0.001). The stage of prolapse was improved in both groups (P < /em><0.001), and it was more significant in the ASC group (P < /em>=0.049). There was no statistically significant difference between the SSLS and ASC in terms of the rate of satisfaction (93% vs. 100%; P < /em>=0.241).Conclusion: According to our findings, ASC and SSLS diminished the symptoms of POP. The surgery approach should be chosen based on the condition of patients, POP stage, and the experience of surgeons.
Obstetrics and Gynecology
Tahereh Eftekhar; Marzieh Hajibabaei; Leila Pourali; Maryam Vizheh; Ali Montazeri
Volume 6, Issue 3 , June 2021, , Pages 128-133
Abstract
Background & Objective: Vaginal laxity is a prevalent disorder that influences woman’s sexual satisfaction and quality of life. This study aimed to evaluate the impact of Higgs radiofrequency on pelvic organ prolapse and sexual function among women suffering from vaginal laxity.Materials & ...
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Background & Objective: Vaginal laxity is a prevalent disorder that influences woman’s sexual satisfaction and quality of life. This study aimed to evaluate the impact of Higgs radiofrequency on pelvic organ prolapse and sexual function among women suffering from vaginal laxity.Materials & Methods: This was a pre- and post-intervention study. Twenty-two subjects who suffered from vaginal laxity referring to a pelvic floor clinic affiliated with Tehran University of Medical Sciences were studied. Higgs radiofrequency was administered at six sessions with a two-week interval. Women were evaluated by an urogynecologist for pelvic organ prolapse quantification (POP-Q) twice: before and three months after intervention. Also, women responded to the Female Sexual Function Index (FSFI-19) at baseline and three months follow-up assessment. Data were analyzed by descriptive statistics and paired samples t-test.Results: The mean age of participants was 40.30 (SD = 8.01) years. The mean number of gravidities was 2.45 (SD = 1.29). Seventeen women (77.3 %) suffered from severe or moderate vaginal laxity. After intervention, the point Ba (P < /em>=0.02), perineal body-point PB (P < /em>=0.058) and total vaginal length (0.014) significantly improved. Also, female sexual function and its six domains improved (P < /em><0.001).Conclusion: The findings indicated that Higgs radiofrequency was a safe and noninvasive technique that improved some pelvic organ prolapse quantification and sexual function among women suffering from vaginal laxity.
