Apikal Pelvik Organ Prolapsusunda Sakrospinöz Ligaman Fiksasyonu ve Uterosakral Ligaman Fiksasyonu Ameliyatlarının Uzun Dönem Sonuçlarının Karşılaştırılması

Yıl 2018, Cilt: 10 Sayı: 3, 381 - 386, 23.10.2018

Gokmen Sukgen , Askı Ellibes Kaya

https://doi.org/10.18521/ktd.462769

Öz

Amaç: Bu çalışmada, apikal pelvik organ prolapsusu (POP) tedavisinde kullanılan sakrospinöz ligaman fiksasyonu (SSLS) ve uterosakral ligaman fiksasyonu (ULS) ameliyatlarının uzun dönem sonuçlarını karşılaştırmayı amaçladık.

Gereç ve Yöntem: Retrospektif çalışmamıza apikal POP tanısı almış 52 hasta dahil edildi. Bu hastaların yirmisi ULS (Grup 1) ile, otuzikisi bilateral SSLS (Grup 2) ameliyatı ile tedavi edildi. Hastane bilgi sisteminden operasyon verilerine, 12. ve 36. aydaki muayene bilgilerine, hasta memnuniyet oranları, objektif ve sübjektif kür oranları ve komplikasyonlara ulaşıldı.

Bulgular: Objektif kür oranları, 12. ayda grup 1’in %80, Grup 2’nin %78.1 iken; 36. ayda Grup 1’in %70, Grup 2’nin %71.8 bulundu (p>0.05). Subjektif kür oranları, 12. ayda grup 1’in %100, grup 2’nin %87.4 iken; 36. ayda grup 1’in %100, grup 2’nin %84.1 olarak saptandı (p>0.05). Memnuniyeti çok olan hastalar ULS grubunda SSLS grubuna kıyasla anlamlı oranda fazla bulundu ancak memnun olan tüm hastalar (çok memnun ve büyük oranda memnun) ile memnun olmayanlar kıyaslandığında, gruplar arası istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05).

Sonuç: Apikal pelvik organ prolapsusu hastalarında vaginal olarak sık uygulanan iki yöntem olan ULS ve SSLS’nin, başarı oranları ve hasta memnuniyetleri kıyaslandığında birbirine üstün olmadığı sonucuna varıldı.

Anahtar Kelimeler

Apikal pelvik organ prolapsusu, apikal prolapsus, uterosakral ligaman fiksasyonu, sakrospinöz ligaman fiksasyonu, pelvik organ prolapsusu

Comparing the Long-Term Outcome of Uterosacral and Sacrospinous Ligament Suspension Surgeries in Apical Pelvic Organ Prolapse

Öz

Objective: We aimed to compare the long-term outcomes of the sacrospinous ligament suspension (SSLS) and uterosacral ligament suspension (ULS) procedures used for the treatment of apical pelvic organ prolapse (POP).

Methods: Fifty-two patients, diagnosed with apical POP, were included in this retrospective study. Twenty of these patients underwent The ULS procedure Fifty-two patients, diagnosed with apical POP, were included in this retrospective study. Twenty of these patients underwent The ULS procedure (Group 1), thirty-two patients (Group 2) were treated with bilateral SSLS. Operation type and time, objective and subjective cure rates, patient satisfaction rates and complications were obtained from hospital records at the operation time and 12-mounts, 36-mounts.

Results: The objective cure rates were 80% of group 1, 78.1% of group 2 at 12-month follow-up and %70 of group 1, 71.8% of group 2 at 36-month follow-up; the subjective cure rates were defined as 100% of group 1, 87.4% of group 2 at 12-month follow-up and %100 of group 1, 84.3% of group 2 at 36-month follow-up (p>0.05). Very satisfied patients were significantly higher in the ULS group compared to the SSLS group (p=0.048) but when compared totally satisfied (very satisfied and greatly improved) and dissatisfied patients, there was no significant difference between groups (p>0.05).

Conclusions: It was found that ULS and SSLS were not superior to each other according to success rates and patient’s satisfaction in the comparison of two commonly used methods apical prolapse by vaginal approach.

Anahtar Kelimeler

Apical pelvic organ prolapse, apical prolapse, uterosacral ligament suspension, sacrospinous ligament suspension, pelvic organ prolapse

Kaynakça

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