LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and Regret.

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY
Journal of Mid-life Health Pub Date : 2024-07-01 Epub Date: 2024-10-17 DOI:10.4103/jmh.jmh_38_24
Themistoklis Mikos, Sofia Tsiapakidou, Matteo Lioupis, Christos Anthoulakis, Iakovos Theodoulidis, Grigoris F Grimbizis
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引用次数: 0

Abstract

Introduction and hypothesis: The aims of this study were to define long-term anatomic outcome, satisfaction rate, and reasons for disappointment and regret in a group of patients with advanced pelvic organ prolapse who underwent LeFort colpocleisis (LFC).

Materials and methods: This was a retrospective, single-center, cohort study including consecutive patients who underwent LFC from 2007 to 2021. All patients had surgery involving vaginal hysterectomy and anti-incontinence procedure where clinically indicated. All patients were examined 3 months after surgery. A cross-sectional telephone survey was performed in 2022 using the Patient Global Impression of Severity (PGI-S), Patient Global Impression of Improvement (PGI-I), and Patient Global Impression of Change (PGI-C) questionnaires, as well as the Decision Regret Scale. Student's t-test, Fisher's Chi-square test, and univariable logistic regression analysis were carried out.

Results: One hundred and forty-one patients (mean age 74.95 ± 6.25 years) were included. The mean preoperative POP Quantification C/D point was +6 (±2.7). In 86 (60.99%) patients, a hysterectomy and in 56 (39.71%), a mid-urethral synthetic sling was performed. At 3-month follow-up, there was one prolapse recurrence (0.71%) and no case of regret of sexual function loss. In the long term, 28 patients died, and 69 patients were interviewed through telephone (follow-up 61.65 months). The mean PGI-S, PGI-I, and PGI-C scores were 1.42 (±0.81), 1.93 (±1.45), and 5.91 (±1.69) respectively, and no patient declared regret about vaginal intercourse loss. Preoperative and postoperative persistent or de novo mixed UI appeared to be related to decreased satisfaction and regret post-LFC (P = 0.0021).

Conclusion: LFC is a valuable, easy-to-perform technique with long-lasting results and decreased postoperative anti-incontinence rates. However, de novo or persistent urinary incontinence appears to be related to decreased satisfaction rates.

左阴道炎:对泌尿系统症状纠正的未满足期望与失望和后悔有关。
前言和假设:本研究的目的是确定一组晚期盆腔器官脱垂患者接受LeFort阴道裂术(LFC)的长期解剖结果、满意率以及失望和后悔的原因。材料和方法:这是一项回顾性、单中心、队列研究,包括2007年至2021年连续接受LFC的患者。所有患者均行阴道子宫切除术和临床指征的防尿失禁手术。所有患者术后3个月复查。在2022年进行了一项横断面电话调查,使用了患者严重程度总体印象(PGI-S)、患者改善总体印象(PGI-I)和患者变化总体印象(PGI-C)问卷以及决策后悔量表。采用学生t检验、Fisher卡方检验和单变量logistic回归分析。结果:纳入141例患者,平均年龄74.95±6.25岁。术前平均POP量化C/D点为+6(±2.7)。86例(60.99%)患者行子宫切除术,56例(39.71%)患者行中尿道合成吊带。随访3个月,脱垂复发1例(0.71%),无一例因性功能丧失而后悔。长期随访28例死亡,电话随访69例(随访61.65个月)。PGI-S、PGI-I和PGI-C的平均评分分别为1.42(±0.81)、1.93(±1.45)和5.91(±1.69)分,无患者对阴道性交失败表示后悔。术前和术后持续性或新生混合性尿失速与lfc术后满意度和后悔率降低有关(P = 0.0021)。结论:LFC是一种有价值的、易于操作的技术,效果持久,降低了术后尿失禁率。然而,从头开始或持续尿失禁似乎与满意度下降有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Mid-life Health
Journal of Mid-life Health Social Sciences-Health (social science)
CiteScore
1.70
自引率
9.10%
发文量
39
审稿时长
43 weeks
期刊介绍: Journal of mid-life health is the official journal of the Indian Menopause society published Quarterly in January, April, July and October. It is peer reviewed, scientific journal of mid-life health and its problems. It includes all aspects of mid-life health, preventive as well as curative. The journal publishes on subjects such as gynecology, neurology, geriatrics, psychiatry, endocrinology, urology, andrology, psychology, healthy ageing, cardiovascular health, bone health, quality of life etc. as relevant of men and women in their midlife. The Journal provides a visible platform to the researchers as well as clinicians to publish their experiences in this area thereby helping in the promotion of mid-life health leading to healthy ageing, growing need due to increasing life expectancy. The Editorial team has maintained high standards and published original research papers, case reports and review articles from the best of the best contributors both national & international, consistently so that now, it has become a great tool in the hands of menopause practitioners.
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