Valutazione prospettica dei sintomi del basso tratto urinario e della funzione anorettale in donne sottoposte ad isterctomia vaginale e riparazione del pavimento pelvico per prolasso degli organi pelvici: effetti sulla qualità di vita

BACKGROUND Pelvic organ prolapse may occur in up to 50% of parous women. A variety of urinary, bowel and sexual symptoms may be associated with prolapse. Female urinary incontinence is a common yet distressing condition. OBJECTIVE To evaluate the evolution of the pelvic organ prolapse (POP) and the lower urinary tract symptoms after vaginal surgical repairs during a follow-up period of three years. STUDY DESIGN 44 post-menopausal women with symptomatic genital prolapse (POP) and urinary, bowel and sexual symptoms, were enrolled and asked to complete the †˜King's health questionnaire'. The patients were divided into two groups: A) patients (35/44) with POP and both urinary and bowel symptoms who were treated by vaginal hysterectomy, bilateral ovariectomy, anterior and posterior vaginal wall repair; B) patients with POP and urinary symptoms who underwent to a vaginal hysterectomy, bilateral ovariectomy and anterior vaginal wall repair. RESULTS There were no significant differences between the two groups of women in occurrence of surgical complications and about short and long-term results. We observed a great improvement both for the genital prolapse and urinary and bowel symptoms, with a better quality of life as assumed from the †˜patient global impression: improvement' (PGI) questionnaire and by clinical investigations during the follow-up period. Better results were observed for the POP symptoms and stress urinary incontinence, urge incontinence and mixed incontinence, with a mean reduction of more then 60%. In conclusion vaginal repair seems to improve POP and low tract urinary symptoms and ameliorate the quality of life.