Genital prolapse: contemporary aspects of surgical treatment (literature review)

The problem of surgical treatment of a genital prolapse remains to be urgent. Many researches have shown that a genital prolapse is a widely spread disease among 11,4-41% of women with a tendency to growth with age and a risk of surgical treatment of the disease in 2,7-11% of cases. The only effective method of treatment of a pelvic organs prolapse and an inconsistency of a pelvic bottom appears as surgical. Operational treatment of a genital prolapse with a use of own tissues is tied up with a high risk of recurrence (up to 40% according to the data of various authors), hereat the risk of repeated operations reaches 17% within next 10 years. The modern surgical concept of pelvic floor plastic surgery is based on the "replacement" of the damaged and inferior pelvic fascia by a new one (creation of neofascia), which provides a reliable skeleton for pelvic organs and neofascia reasonably. Effectiveness of surgical treatment of a genital prolapse with the use of polypropylene mesh reaches 81-95,8%. However, the use of nets for the treatment of PG is accompanied with the risk of complications: erosions of the vaginal mucosa (1-19%); Synechia of the vagina (0.3%); Erosions of the mucous membrane of the bladder (0.2%); Urethro-vaginal fistula (0.15%); Contraction of the prosthesis (1%); Chronic pain syndrome (2.9-18.3%); Dyspareunia de novo (2.2-27.7%); Infection (0.6%); Extrusion of nets (0-30%). Possible causes of the implant (mesh) -associated complications are: unreasonable use of reticular implants in the correction of PG; Features of the technical execution of the operation; hysterectomy. In this respect working out of concrete indications for polypropylene mesh usage in case of genital prolapse correction and search for preventive measures from possible complications after polypropylene mesh application remain to be the most important tasks.