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Figures in Original Article by NADER GAD, MAAIKE MOLLER

Preliminary retrospective case series study of the outcome of Prolift™ technique in thirty women with pelvic organ prolapse including its effect on stress urinary incontinence.

 

Department of Obstetrics & Gynaecology Royal Darwin Hospital, Darwin, Australia



(Table 1)

Complications

GAD

COSSON

FATTON

Intraoperative

  • Bladder or rectal injury

0

Vesical 4 (0.58%)

Rectal 2 (0.30%)

 
  • Blood loss greater 500ml

1 (3.33%) (note 1)

3 (0.44%)

 
  • Blood transfusion

0

 
 

Immediate postoperative  

  • Infection

0

Cellulitis 1 (0.15%)

Perineal Abscess 2 (0.29%)

Pelvic haematoma 12 (1.75%)

T > 38.5C 2 (1.8%)

UTI 13 (11.8%)

Pelvic abscess 0

Deep haematoma 2 (1.8%)

  • Thromboembolism

0

 
 
  • Urinary retention

0

( note 2)

 

13 (11.8%)

  • Return to theatre

0

 
 
  • Blood transfusion

0

 
 

Medium term postoperative

  • Granuloma formation

0

46 (6.70%)

3 (2.8%)

  • Mesh exposure

0

 

5 (4.7%

  • Urinary or rectal fistula

0

2 (0.30%)

 
  • Mesh contraction

0

19 (2.77%)

18 (17%)

  • Recurrence

0

36 (5.24%)

5 (4.54%)

  • De novo SUI

0

37 (5.39%)

 

Table 1.
-Comparison of the complications of this study with that of Cosson et al.8 and Fatton et al. 12

Note 1: In one patient there was an EBL > 500ml. This woman had a large fibroid uterus with 1st degree uterine prolapse. She requested a hysterectomy at the time of her Prolift due to pressure symptoms caused by the large fibroid uterus. Most of the blood loss occurred during the difficult vaginal hysterectomy part of the procedure and was not associated with the Prolift procedure itself. She did not require blood transfusion. The histology confirmed a large fibroid uterus weighing 481g (150mm x140mm x70mm).

Note 2: There were no cases of urinary retention by conventional definitions. There was one woman who passed 350ml on first void, the nursing staff measured residual urine of 96mls. For no clear indication she re-inserted an indwelling catheter again. On the same day the woman had to leave the hospital to attend to family business with the catheter still in situ. By the time she returned the next morning she had a successful trial after removal of the catheter.



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(Table. 2 )

SUI present before Prolift

Yes
22 patients (73%)

No
8

UDA performed

Yes
19

No
3

No
8

Result of UDA if performed

UDSI
14

no UDSI 4

Inconclusive UDSI
1

 

 

No SI following Prolift

6 (43%)

4 (100%)

0

3 (100%)

8 (100%)

13 (59%)

Presence of SUI following Prolift

8 (57%)
5 had TVT-O &
2 had TVT
1 awaiting surgery

0

1 (100%)
Marked improvement of SUI

0

0

9 (41%)


Table 2
. – Effect of Prolift procedure on associated SUI.




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