Combined Abdominal Sacrocolporectopexy as ReOperation for Repeated Multi-Compartment Pelvic Prolapse

Abstract

Aim: was to improve unsatisfactory results of primary surgery for middle pelvic compartment prolapse with its gradual development in the total pelvic organ prolapse. Material of study: Study group consisted of 17 patients who underwent various corrective operations using their own tissues from the vaginal access for pelvic prolapse in the area of the middle segment of the pelvis: uterine prolapse or vaginal prolapse after hysterectomy. Of these, the previous hysterectomy for uterine prolapse was performed in 7 patients. In terms of 6.5±0.8 years after the primary surgical treatment, they had a repeated combined pelvic prolapse, including prolapse of the uterus or vaginal apex after hysterectomy, i.e. a relapse of the "middle prolapse", as well as a newly developed pelvic prolapse in the area of the posterior segment of the pelvis: rectal prolapse, rectocele of the III degree, perineum descenfence and prolapse in the anterior segment of the pelvis: urethro-vesical segment or bladder. Re-surgery consisted of combined anterior and posterior abdominal sacrocolporectopexy using synthetic grafts and was combined with the Burch urethral suspension technique for the prevention and correction of stress urinary incontinence.