Quality of life as a criterion for the effectiveness of surgical treatment of genital prolapses combined with uterine leiomyoma

Abstract

Criteria for choosing the volume of surgical intervention in patients with genital prolapse combined with uterine leiomyoma have not been developed. Purpose - to evaluate quality of life after hysterectomy with and without correction of genital prolapse. Materials and methods. 120 patients were examined. In the Control (I) Group (n=40), hysterectomy was performed without correction of genital prolapse, in the other two groups - hysterectomy and correction of genital prolapse using a mesh implant by the method of pectopexy (the Group II, n=40) or lateral fixation (the Group III, n=40). The PFDI-20, PISQ and PD-QOL questionnaires were used to assess the quality of life after the operation. Statistical analysis was performed with SPSS Version 21.0. Results. Significant differences in the average number of points were registered in the Group II and Group III - 45.39±27.02 and 49.78±17.24 points respectively; p<0.001. The sexual function index also significantly increased: from 18.93±14.61 to 24.85±12.19 points in the Group II and from 17.55±10.64 to 24.30±13.92 points in the Group III (р=0.01). During the analysis 12 months post surgery, attention was drawn to reliable differences in the average estimates of the impact of manifestations of genital prolapse on the quality of life (the PD-QOL questionnaire), physical and social limitations, interpersonal relationships and emotional problems in the Group II/Group III compared to patients in the Group I (p<0.05). Conclusions. The data we obtained allow us to talk about the effectiveness of simultaneous correction of genital prolapse with hysterectomy using mesh implants. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.