title: [Prospective study on total pelvic reconstruction surgery with Prosima in the treatment of pelvic organ prolapse stage III].
abstract: OBJECTIVE
  To evaluate the safety and efficacy of total pelvic reconstruction surgery with Prosima in treatment of pelvic organ prolapse (POP) stage III.
  
  
  METHODS
  From July 2010 to December 2011, 31 patients with POP stage III undergoing total pelvic reconstruction surgery with Prosima were enrolled in this prospective study. Among two cases complicated with stress urinary incontinence underwent transobturator tension-free vaginal tape concomitantly with total pelvic reconstruction surgery with Prosima. Clinical parameters during peri-operation were recorded and compared. Pelvic organ prolapse quantitative examination (POP-Q) and anatomic improvement in these patients after surgery were analyzed. Comparisons of pelvic floor impact questionnaire-short form 7 (PFIQ-7) and pelvic organ prolapse-urinary incontinence sexual questionnaire-short form 12 (PISQ-12) in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.
  
  
  RESULTS
  The mean operating time was (55 ± 13) minutes, mean blood loss was (66 ± 25) ml. No severe intraoperative complications were observed. All patients were able to recover spontaneous micturation within 5 days. Two cases experienced pelvic hematoma with diameters less than 7 cm, and resolved later. Another case was urinary tract infection. At the median follow-up 6 months (1 - 15 months), the rate of anatomic success defined as the leading vaginal edge above the hymen was 94% (29/31). There were significant improvements in Aa, Ba, Ap, Bp, and C (P < 0.01) by POP-Q. Two patients showed recurrent prolapse at 3 months and 1 year after surgery, without the need of further operation. The median score of post-operative PFIQ-7 was 0 point at 6 months and 0 point at 12 months after operation, respectively, which were significantly lower than that of 50 points pre-operation (P < 0.01). And there was no significant difference in the average score of PISQ-12 before and after surgery [(30 ± 6) points versus (31 ± 4) points] (P > 0.05). The rate of mesh exposure was 16% (5/31), all the 5 cases occurred within 6 months and was cut in clinic. There was no case of de novo urinary incontinence and de novo dyspareunia.
  
  
  CONCLUSIONS
  Pelvic reconstruction surgery with Prosima is safe and efficacy in treatment of POP stage III. It could improve quality of life remarkably without influence on sexual quality of life.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.forename: Lan
authors.initials: L
authors.lastname: Zhu
authors.forename: Jing-he
authors.initials: JH
authors.lastname: Lang
authors.forename: Hong-hui
authors.initials: HH
authors.lastname: Shi
authors.forename: Wen-jia
authors.initials: WJ
authors.lastname: Lou
authors.forename: Zhi-jing
authors.initials: ZJ
authors.lastname: Sun
authors.forename: Xiao-ming
authors.initials: XM
authors.lastname: Gong
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal; D008875:Middle Aged; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D010570:Pessaries; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012720:Severity of Illness Index; D013526:Surgical Mesh; D011795:Surveys and Questionnaires / Q000592:standards; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery