Дата публикации в реестре: 2025-05-27T14:28:25Z

Аннотация:

Methods of correction of vaginal vault prolapse (VVP) after hysterectomy for various benign diseases have been studied in numerous randomized clinical trials (RCTs), but a systematic analysis of this topic is currently lacking. Objective. To compare the efficacy of VVP correction after total hysterectomy in a systematic review based on the most reliable data from RCTs. Materials and methods. A review of the literature published between 2019 and 2024 was conducted, searched in PubMed and Embase databases. Only RCTs addressing post-hysterectomy apical prolapse with at least 30 patients and a follow-up of atleast 6 months were included in this review. Results. A total of 10 RCTs involving 3419 patients (42 to 1812 women) met the inclusion criteria for the analysis. Almost all surgical techniques were associated with favorable subjective outcomes. Laparoscopic sacrocol popexy (LSCP) was associated with a higher level of satisfaction. Sacrocolpopexy (laparotomic and endoscopic) had the best anatomic results (78.6–84.6%).Sacrospinous fixation had the worst results (SSF; 35–81%), which also correlated with a higher rate of recurrences requiring repeat surgical treatment (7.7–21.8%) and a higher rate of intraoperative complications of various grades according to the Clavien-Dindo classification (27.2%). Mesh endoprosthesis exposure was most frequently observed in LSCP (12.5%), but in general this scope of surgical intervention showed better results in retrospective follow-up. Conclusion. Despite the variety of correction methods, the question of the most effective, reliable and safe way to eliminateapical prolapse occurring soon after uterine extirpation remains unresolved. © Издательство «Династия», 2024.

Тип: Article

Источник: Voprosy Ginekologii, Akusherstva i Perinatologii