Impact of Laparoscopic promontofixation on sexuality and quality of life
Amri, M1; Jallouli, W2; Maatouk, H3; Ben Khalifa, B2; Saadi, H2; Ati, N4; Lahwar, R2; Naouar, S2; Salem, B2; ElKamel, R2
1: ibn El Jazzar Teaching Hospital of Kairouan , Tunisia; 2: Ibn El Jazzar Teaching Hospital of Kairouan , Tunisia; 3: Fattouma Bourguiba Teaching Hospital of Monastir; 4: Taher Sfar Teaching Hospital of Mahdia
Objective: Pelvic organ prolapse (POP) is a frequent anomaly; however, its prevalence remains underestimated. Laparoscopic promontofixation has been widely adopted as the treatment of choice of POP in sexually active young female. The aim of this study was to determine the impact of this technique on sexuality and quality of life based on validated questionnaires.
Methods: A retrospective cross-sectional study was carried out including 30 women with POP treated with laparoscopic promontofixation at the urology department of Ibn El Jazzar Teaching Hospital of Kairouan between 2012 and 2016.
Results: The mean age of our patients was 58.1 ± 7.2 years with a mean parity of 6 children. The main presentations were vaginal bulge and discomfort (83.3%) and urinary incontinence (80%). All the patients had at least a grade 2 prolapse with an associated stress urinary incontinence in 18 cases among them 4 were masked and revealed after manually prolapse reducing. Preoperatively, all the patients responded the PFDI-20 and the PFIQ-7 questionnaire; only 20 patients responded the PISQ-12 questionnaire. Twenty two patients underwent double sacrocolpopexy while 8 underwent only anterior sacrocolpopexy. Transobturator tape placement was performed in 18 cases. The mean operative time was 225.5 minutes. Anatomic success was noted at the first month and the 6th one, postoperatively. Globally, there was a significant improvement in the PFDI-20, PFIQ-7 and PISQ-20 questionnaire at the moment of the investigation.
Conclusion: Laparoscopic promontofixation remains the technique of choice to manage POP in young female. Its impact on sexuality and quality of life has been demonstrated
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