A Foley catheter i. A gauze vaginal packing is also placed at the end of the procedure. Blood loss during laparoscopic colposuspension is routinely less than cc and transfusions are rarely required. Figure 3. Schematic sagittal view of laparoscopic colposuspension with mesh graft. Although laparoscopic colposuspension has proven to be very safe, as in any surgical procedure there are risks and potential complications.
Potential risks include:. Bleeding : Although blood loss during this procedure is relatively low compared to open surgery, a transfusion may still be required if deemed necessary either during the operation or afterwards during the postoperative period.
Infection : All patients are treated with intravenous antibiotics, prior to the start of surgery to decrease the chance of infection from occurring within the urinary tract or at the incision sites. Transient injury to nerves or muscles can also occur related to patient positioning during the operation. Hernia : Hernias at the incision sites rarely occur since all keyhole incisions are closed under direct laparoscopic view. Conversion to Open Surgery : The surgical procedure may require conversion to the standard open operation if extreme difficulty is encountered during the laparoscopic procedure e.
This could result in a standard open incision and possibly a longer recuperation period. Urinary Incontinence : Pre-existing urinary incontinence will typically be addressed at the time of surgery with a bladder sling suspension, however, minor incontinence may still exist, which typically resolves with time. Prevalence of POP increases with age. 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 requires an evaluation of the appropriate surgical management since women in this age group may be candidates for all types of surgical repair. A full-thickness dissection is performed laterally and apically to the ischial spine. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. The study involves elderly females over 70 years old with advanced pelvic organ prolapse. Criteria Inclusion Criteria:. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information.
Search for terms. Save this study. Warning You have reached the maximum number of saved studies Different Surgical Techniques Used for Prolapse Repair in Elderly Patient The safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Listing a study does not mean it has been evaluated by the U. Federal Government. Read our disclaimer for details. Last Update Posted : March 22, Study Description. 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:. 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.
Vaginal mesh repair surgery VMR is performed using a single-incision mesh system. Outcome Measures. Primary Outcome Measures : Post-operative complications [ Time Frame: 12 months follow-up ] All complications are recorded, corresponding to Clavien Dindo classification. Secondary Outcome Measures : Anatomical success rate [ Time Frame: 12 months follow-up ] Assessed by recovery time and anatomical correction.
Eligibility Criteria. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. The study cohort is selected from our institution. Contacts and Locations. Doctors may suggest surgery if other treatments have failed, and many times, surgery is chosen when a vaginal pessary is either not desired or cannot be retained comfortably.
There are several different surgical techniques which are effective. In addition to the experience and training of the surgeon, specific choices offered depend on your:. Whether or not to have surgery for prolapse is an individual decision. The success or failure of someone else's operation should never be the deciding factor for you.
Every woman's situation is different. There is no single operation that is right for every patient. You and your surgeon must decide on the best option together. Surgery is a major decision you must make with your physician. You may find the tools below helpful in preparing for surgery. One presents questions to ask your doctor during your pre-op visit, providing an overview of what you can expect when preparing for surgery, and general recommendations for how you can prepare for surgery.
The other offers information about mesh. Pelvic surgeries can help restore the normal pelvic floor anatomy or repair damaged muscles or tissue. Many procedures to correct pelvic organ prolapse can be performed through small incisions in the vagina or abdomen laparoscopic or robotic-assisted techniques , which may reduce scarring and complications and may shorten recovery time. Apical suspension surgery restores the support of the top of the vagina, which is also called the vaginal apex or vault, and helps to maintain sexual function.
There are two common surgical approaches to apical suspension. Sacrocolpopexy The sacrocolpopexy also called sacral colpopexy can be performed through an abdominal incision about 6 inches long , laparoscopically with or without robotic assistance through half-inch incisions. In this procedure, straps of permanent medical mesh graft material are used to reinforce the front and back walls of the vagina. These straps are then attached to a strong ligament overlying the sacrum.
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