Prevention of intraoperative and mesh-associated complications after transvaginal extraperitoneal surgery for pelvic organ prolapse
Автор: Kolsanova A.V., Katorkina E.S., Kolsanov A.V., Minnullina F.F., Katorkin S.E., Chemidronov S.N.
Журнал: Ульяновский медико-биологический журнал @medbio-ulsu
Рубрика: Клиническая медицина
Статья в выпуске: 2, 2025 года.
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Mesh implants in reconstructive surgery for pelvic organ prolapse (POP) can cause intraoperative and mesh-associated complications reducing the quality of life. The aim of the study is to reduce the incidence of intraoperative and mesh-associated complications by personalized 3D modeling, planning and intraoperative navigation. Materials and Methods. The authors conducted a prospective randomized study of 93 patients operated on using trocar and anchor mesh systems. In groups 1 (n=32) and 2 (n=30), trocar and anchor mesh systems were used, respectively, without 3D modeling. In group 3 (n=31), 3D modeling for pelvic organs, planning, and intraoperative navigation were used during anchor mesh system installation. The operative time, blood loss, peri- and postoperative complications were recorded. Treatment effectiveness was determined by achieving anatomical cure: stage POP-Q ≤1. Results. 3D modeling and surgical navigation used in group 3 allowed us to reduce the surgical trauma, blood loss, the number of hematomas, and to exclude pelvic trauma. In group 1, there was 1 case (3.1 %) of intraoperative urethra and bladder injury and ureteral tamponade. In group 2, 1 person (3.3 %) had a bladder injury. Blood loss volume in group 1 was 268.6±25.8 ml, in group 2 – 67.8±54.6 ml, in group 3 – 59.4±23.6 ml. In a 3-month pe-riod in group 1 mesh complications included: vaginal mucosa erosion in 3 (9.4 %) patients, vaginal adhesions in 1 (3.1 %) patient, mesh shrinkage in 1 (3.1 %) patient, dyspareunia and pain in 5 (15.6 %) patients. In groups 2 and 3, vaginal mucosa erosion was detected in 2 (6.7 %) and 1 (3.2 %) patient, re-spectively. Anatomical success was achieved in 91.4 % of patients. Conclusions. Preoperative 3D modeling and intraoperative navigation contribute to POP surgery, which takes into account individual topographic characteristics and reduces the number of complications.
Anterior apical mesh repair, 3D modeling, surgical navigation, mesh compli-cation, pelvic organ prolapse, transvaginal mesh, operative gynecology
Короткий адрес: https://sciup.org/14132988
IDR: 14132988 | DOI: 10.34014/2227-1848-2025-2-78-93