Surgical correction of neurological disorders with perineal prolapse in women
Pelvic organ and pelvic floor prolapse is an urgent problem of modern medicine due to the high frequency of occurrence: more than 50 % in women over 50 years old. The aim of this research was to evaluate the effectiveness of correction of neurological disorders in women with perineum (pelvic floor) prolapse by sacrocolporectopexy in combination with stapler trans anal resection of the rectal mucosa (STARR). The results of restoration of the continent function were studied in 52 patients aged 35 to 67 years (47.6 ± 5.6 years), in whom, as a result of surgical treatment, correction of anatomical disorders was achieved with normalization of the function of emptying the rectum during defecation. Surgical treatment included sacrocolporectopexy according to D'Hoore in combination with stapler trans anal resection of the rectum mucosa (STARR) according to A.Longo. The patients were examined 6 and 12 months after surgery with anorectal manometry and electromyography. The patients' subjective assessment of the improvement of the intestinal continent function was confirmed. After 12 months, the pressure indicators in the area of the external anal sphincter were 43.1 ± 3.4 mm Hg at normal values of 48.8 ± 3.2 mm Hg, in the area of the internal sphincter - 55.2 ± 4.6 mm Hg at normal values of 59.8± 6.2 mm Hg (P > 0.05). This is due to the cessation of overextension of the sacral nerve as a result of the fact that the perineum after surgical treatment occupies its normal anatomical level, which is confirmed by a decrease in its latency period from 2.89 ± 0.5 ms to 2.39 ± 0.5 ms.
Oleynik N.V., Krivchikova A.P., Yarosh A.L., Bratisheva N.N., Leshenko A.S., Karpachev A.A. 2022. Surgical correction of neurological disorders with perineal prolapse in women. Challenges in Modern Medicine. 45 (2): 207–316 (in Russian). DOI: 10.52575/2687-0940-2022-45-2-207-216
While nobody left any comments to this publication.
You can be first.
Vorob'ev A.A., Solov'ev A.O., Solov'ev O.L., Pylaeva I.O., Bagrij E.G. i dr. 2021. Klinicheskaja anatomija zhenskoj promezhnosti [Clinical anatomy of the female perineum]. SPb.: IP Makov M. Ju. 320 s. - ISBN 978-5-6046024-6-1.
Krivchikova A.P. Rol' sakrokol'porektopeksii v kompleksnom hirurgicheskom lechenii sindroma opushhenija promezhnosti u zhenshhin [The role of sacrocolporectopexy in the complex surgical treatment of perineal prolapse syndrome in women]. 2019. Avtoref. diss. kand. med. nauk. FGAOU VO «Belgorodskij gosudarstvennyj nacional'nyj issledovatel'skij universitet».
Kulikovskij V.F., Olejnik N.V., Krivchikova A.P., Bratishheva N.N. 2018. Preimushhestva vnutribrjushnoj sakrokol'porektopeksii, dopolnennoj steplernoj transanal'noj rezekciej slizistoj prjamoj kishki v hirurgicheskom lechenii tazovogo prolapsa [Advantages of intra-abdominal sacrocolporectopexy supplemented with stapler transanal resection of the rectal mucosa in the surgical treatment of pelvic prolapse]. Nauchnye vedomosti BelGU. Ser. Medicina. Farmacija. 41 (1): 5–13.
Chaudhry Z., Tarnay С. 2016. Descending perineum syndrome: a review of the presentation, diagnosis, and management. Int. Urogynecology Journal. 27 (8): 1149–1156. Cross. Ref.
D’Hoore A., Cadoni R., Penninckx F. 2004. Along-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br. J. Surg. 91 (11): 1500–1505.
Ding S. 2017. Pelvic floor biofeedback therapy in pelvic floor diseases. Zhonghua Wei Chang Wai Ke Za Zhi. 20 (12): 1351–1354.
Houman J., Weinberger J.M., Eilber K.S. 2017. Native Tissue Repairs for Pelvic Organ Prolapse. Curr. Urol. Rep. 18 (1): 6. doi: 10.1007/s11934-017-0648-0. PMID: 28155202 Review.
Klapdor R., Grosse J., Hertel B., Hillemanns P., Hertel H. 2017. Postoperative anatomic and quality-of-life outcomes after vaginal sacrocolporectopexy for vaginal vault prolapse. Int. J. Gynaecol. Obstet. 137 (1): 86–91. doi: 10.1002/ijgo.12095.
Kulikovsky V.F., Oleynik N.V., Bratisheva N.N., Krivchikova A.P., Alenicheva M.S. 2018. Posterior colporrhaphy and levatoroplasty versus abdominal sacral colpopexy combined with stapled trance-anal resection (STARR) for the surgical treatment of rectocele concomitant with rectal mucosal prolapse. International Journal of Advanced Biotechnology and Research. 9 (1): 1022–1027.
Kulikovsky V.F., Oleynik N.V., Krivchikova A.P., Braticheva N.N. 2020. Combined abdominal sacrocolporectopexy as re-operation for repeated multi-compartment pelvic prolapse. J. Cardiovasc. Disease Res. 11 (4): 81–86.
Lin H.C., Chen H.X., He Q.L., Huang L., Zhang Z.G., Ren D.L. 2018. A Modification of the Stapled Trans Anal Rectal Resection (STARR) Procedure for Rectal Prolapse. Surg Innov. 25 (6):
578–585. doi: 10.1177/1553350618793415.
Longo A. Treatment of hemorrhoid disease by reduction of mucosa and hemorrhoid prolapse with a circular suturing device: a new procedure. 1998. Proceedings of the Sixth World Congress of Endoscopic Surgery. P. 777–784.
Nessi A., Kane A., Vincens E., Salet-Lizée D., Lepigeon K., Villet R. 2018. Descending Perineum Associated with Pelvic Organ Prolapse Treated by Sacral Colpoperineopexy and Retrorectal Mesh Fixation: Preliminary Results. Front. Surg. 20; 5: 50. doi: 10.3389/fsurg.2018.00050.
Oleynik N.V., Kulikovsky V.F., Abulatifa A., Krivchikova A.P., Bratisheva N.N., Alenicheva M.S., Storojilov D.A., Naumov A.V. 2020. Could the results of posterior colporrhaphy and levatoroplasty be improved by abdominal sacrocolporectopexy? Ann. Ital. Chir. 91 (2): 220–224.
Oleynik N.V., Krivchikova A.P., Jarosh A.L., Bratisheva N.N. 2021. Disorders of Pelvic Floor Innervation and its Surgical Correction in Patients with Perineum Prolapse. 17 International Conference on Neurology and Spine Disorders (SciTech Central Neurology 2021) held during April 23, 2021. Journal of Neurosurgery Imaging and Techniques JNSIT, 6 (S1): 12. ISSN: 2473-1943. www.scitcentral.com
Piloni V., Possanzini M., Bergamasco M., Santi G. 2017. Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre Experience. Gastroenterol. Res. Pract. doi: 10.1155/2017/4392918.
Ripamonti L., Guttadauro A., Lo Bianco G., Rennis M., Maternini M., Cioffi G., Chiarelli M., De Simone M., Cioffi U., Gabrielli F. 2022. Stapled Transanal Rectal Resection (Starr) in the Treatment of Obstructed Defecation: A Systematic Review. Front Surg. 14(9): 790287. doi: 10.3389/fsurg.2022.790287. eCollection 2022. PMID: 35237648.
Sharma A., Rao S.S.C. 2020. Epidemiologic Trends and Diagnostic Evaluation of Fecal Incontinence. Gastroenterol Hepatol (N Y). 16 (6): 302–309.
van Zanten F., Schraffordt Koops S.E., Pasker-De Jong P.C.M., Lenters E., Schreuder H.W.R. 2019. Learning curve of robot-assisted laparoscopic sacrocolpo(recto)pexy: a cumulative sum analysis. Am. J. Obstet. Gynecol. 221 (5): 483. e1-483.e11. doi: 10.1016/j.ajog.2019.05.037.
Wang X.J., Chedid V., Vijayvargiya P., Camilleri M. 2020. Clinical Features and Associations of Descending Perineum Syndrome in 300 Adults with Constipation in Gastroenterology Referral Practice. 65 (12): 3688–3695. doi: 10.1007/s10620-020-06394-0.
Weintraub A.Y., Glinter H., Marcus-Braun N. 2020. Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. Int. Braz. J. Urol. 46 (1): 5–14. doi: 10.1590/S1677-5538.IBJU.2018.0581.