Surgical Management of Pelvic Organ Prolapse in Ethiopian Women: What Is the Preferred Approach?

Kimberly Kenne, Melaku Abreha, Kyle D. Hart, W. Thomas Gregory, Rahel Nardos

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives The aim of this study was to determine the most effective approach to surgical repair of pelvic organ prolapse for Ethiopian women and to characterize this population. Methods This is a prospective cohort study of women presenting for prolapse repair. Demographics and assessments of prolapse were obtained preoperatively. Information surrounding the surgical encounter was collected. The same anatomic and symptomatic measures were ascertained postoperatively. Information regarding surgical complications was collected. Results Two hundred thirty-three women with stage III or IV prolapse underwent surgical prolapse repair between March 2015 and November 2017. Seventy-eight of these women participated with a median length of follow-up of 255 days. All of the sacrocolpopexy patients (n = 21) and 56 of 57 vaginal repair patients had follow-up anatomic data. Anatomic failure as defined by Pelvic Organ Prolapse-Quantification (Ba, C, or Bp > 0) occurred in 0% (0/21) of sacrocolpopexy patients and 34% (19/56) of vaginal repair patients (P = 0.005). Symptomatic failure, as defined by self-reported recurrence of vaginal bulge, occurred in 0% (0/21) of sacrocolpopexy patients and 23% (13/56) of vaginal repair patients (P = 0.015). A global assessment of improvement (worse, same, or improved) revealed that 100% (21/21) of sacrocolpopexy patients reported improvement, whereas 91% (50/55) of vaginal repair patients reported improvement, 7% (4/55) reported being the same, and 2% (1/55) reported being worse. There were 2 intraoperative complications and 3 postoperative complications. There were no cases of mesh erosion. Conclusions Although both vaginal and abdominal routes of prolapse surgery seem to be safe, an abdominal approach with mesh augmentation may be the preferred surgical repair in Ethiopian women.

Original languageEnglish (US)
Pages (from-to)E7-E12
JournalFemale Pelvic Medicine and Reconstructive Surgery
Volume26
Issue number2
DOIs
StatePublished - Feb 1 2020

Bibliographical note

Funding Information:
From the *University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Iowa City, IA; †Hamlin Fistula Ethiopia, Mekelle, Ethiopia; ‡Oregon Health & Science University; and §Kaiser Permanente Northwest, Portland, OR. Correspondence: Kimberly Kenne, MD, MCR, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 42242. E-mail: kimberly-kenne@uiowa.edu. Support: Worldwide Fistula Fund, Tartar Trust Fellowship. The authors have declared they have no conflicts of interest. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/SPV.0000000000000836

Keywords

  • Ethiopia
  • pelvic organ prolapse
  • prolapse
  • surgical repair

PubMed: MeSH publication types

  • Journal Article

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