Anterior colporrhaphy under local anesthesia

Česká verze

Authors: J. Vláčil ¹; M. Halaška ¹; O. Šottner ¹; K. Maxová ¹; M. Kotoulová ¹; I. Malá ²
Authors place of work: Gynekologicko-porodnická klinika 1. LF UK a Nemocnice Na Bulovce, Praha, přednosta prof. MUDr. M. Halaška, DrSc. ¹; Fakulta informatiky a statistiky, Katedra statistiky a pravděpodobnosti VŠE, Praha, vedoucí katedry prof. Ing. R. Hindls, CSc., dr. h. c. ²
Published in the journal: Ceska Gynekol 2015; 80(1): 45-49

Summary

Objective:
To evaluate the advantage of the usage of local anesthesia for vaginal surgery in gerontological patients.

Design:
Prospective study.

Setting:
Charles University in Prague, 1st Medical Faculty and Hospital Bulovka, Department of Obstetrics and Gynaecology, Prague.

Methods:
43 patients over 60, 4 were younger, with diagnosed descent of anterior vaginal wall G II–III according to International Continence Society classification, were included into the study. They underwent anterior vaginal wall repair in the sole local anesthesia. For the assessment of the procedure, we used anamnestic data and quality of life questionnaires Visual analogue scale, International Consultation on Incontinence Questionnaire – Short Form, Pelvic Floor Distress Inventory – 20.

Results:
The results of used questionnaires confirmed positive results of the local anesthesia. We demonstrated statistically significant improvement of the urinary incontinence too, as well as subjective perception of the descent.

Conclusion:
Excellent subjective assessment of usage of local anesthesia showed us new operative possibility in treatment applicable in high-risk patients.

Keywords:
urogynaecology, anterior colporrhaphy, local anesthesia, geriatric (high-risk) patient

Zdroje

1. Altman, D., Väyrynen, T., Engh, ME., et al. Anterior colpor-rhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med, 2011, 12, 364, p. 1826–1836.

2. Axelsen, SM., Bek KM. Anterior vaginal wall repair using local anaesthesia. Eur J Obstet Gynecol Reprod Biol, 2004, 10, 112, p. 214–216.

3. Barnett, RM. The modern Kelly plication. Obstet Gynecol, 1969, 34, 5, p. 667–669.

4. Buchsbaum, GM., Duecy, EE. Local anesthesia with sedation for transvaginal correction of advanced genital prolapse. Am J Obstet Gynecol, 2005, 193, 6, p. 2173–2176.

5. Chmel, R., Vlk, R., Rob, L., Hořčička, L. The Barnett-Macku method of anterior colporrhaphy in the prevention and treatment of urinary stress incontinence in women with cystocele. Ces Gynek, 2003, 68, 1, p. 17–21.

6. Fothergill, WE. Anterior colporrhaphy. Am J Surg, 1915, 29, p. 162.

7. Greisen, S., Glavind-Kristensen, M., Bek, KM., Axelsen, SM. Subjective and objective results of anterior vaginal wall repair in an outpatient clinic: a 5-year follow-up. Int Urogynecol J, 2012, 23, 7, p. 883–886.

8. Kringel, U., Reimer, T., Tomczak, S., et al. Postoperative infections due to bladder catheters after anterior colporrhaphy: a prospective, randomized three-arm study. Int Urogynecol J, 2010, 21, 12, p. 1499–1504.

9. Luger, TJ., Kammerlander, C., Luger, MF., et al. Mode of anesthesia, mortality and outcome in geriatric patients. Z Gerontol Geriatr, 2014, 47, 2, p. 110–124.

10. Martan, A., Švabík, K., Mašata, J., et al. Correlation between stress urinary incontinence or urgency and anterior compartment defect before and after surgical treatment. Ces Gynek, 2010, 75, 2, p. 118–125.

11. Olsen, AL., Smith, VJ., Bergstrom, JO., et al. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol, 1997, 89, 4, p. 501–506.

12. Rudnicki, M., Laurikainen, E., Pogosean, R., et al. Anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse: a randomised controlled trial. BJOG, 2014, 121, 1, p. 102–110.

13. Shahghaibi, S., Faizi, S., Gharibi, F. Effect of colporrhaphy on the sexual dysfunction of women with pelvic organ prolapsed. Pak J Med Sci, 2013, 29, 1, p. 157–160.

14. Sørensen, J., Axelsen, SM. Cost-minimisation analysis of vaginal wall repair in an inpatient or outpatient regimen. Acta Obstet Gynecol Scand, 2007, 86, 4, p. 473–479.

15. Šottner, O., Halaška, M., Vláčil, J., et al. A comparison of different types of suburethral slings in the treatment of urinary incontinence in geriatric patients. Ces Gynek, 2012, 77, 5, p. 403–407.

16. Weber, AM., Walters, MD. Anterior vaginal prolapse: review of anatomy and techniques of surgical repair. Obstet Gynecol, 1997, 89, 2, p. 311–318.

17. Wong, V., Shek, KL., Goh, J., et al. Cystocele recurrence after anterior colporrhaphy with and without mesh use. Eur J Obstet Gynecol Reprod Biol, 2014, 172, p. 131–135.