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Magnetic resonance imaging of abdominal versus vaginal prolapse surgery with mesh
Ist Teil von
International Urogynecology Journal, 2012-11, Vol.23 (11), p.1569-1576
Ort / Verlag
London: Springer-Verlag
Erscheinungsjahr
2012
Quelle
MEDLINE
Beschreibungen/Notizen
Introduction and hypothesis
We compared two surgical approaches in patients with symptomatic prolapse of the vaginal apex with normal controls by analyzing pelvic landmark relationships measured using magnetic resonance imaging (MRI) before and after surgery.
Methods
In this prospective multicenter pilot study involving 16 participants, nulliparous controls (
n
= 6) were compared with ten parous (3.0 ± 1.0) women with uterine apical prolapse equal to or greater than stage 2. Group A (
n
= 5) underwent abdominal sacral colpopexy with monofilament polypropylene mesh and group B (
n
= 5) with vaginal mesh kit repair (Total ProLift). Subtotal hysterectomy was performed in all group A and no group B women. All patients underwent preoperative and 3-month postoperative Pelvic Organ Prolapse Quantification (POP-Q) and dynamic MRI. Comparison of MRI pelvic angles and distances was performed and analyzed by Mann–Whitney rank sum test and chi-square test.
Results
Vaginal apical support is similar at 3 months for abdominal sacral colpopexy (ASCP) and ProLift by POP-Q examination and MRI analysis. In both treatment groups, the postoperative POP-Q point C and MRI parameters were similar to nulliparous controls at 3 months.
Conclusions
Anatomic outcomes for ASCP compared with ProLift were similar at 3 months in terms of vaginal apical support by POP-Q and MRI analysis. Continued comparative analysis of postoperative support with objective imaging seems warranted.