[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-134018-en":3,"doc-seo-134018-105":30,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":11,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},134018,5909877438554,"Maeve","https://ap-avatar.wpscdn.com/avatar/5600025385ad2bf12a7?_k=1778553567797529272",7,"Healthcare","Comparison of effectiveness of vaginal and abdominal routes in treating severe uterovaginal or vault prolapse - Abstract","Retrospective evidence compares abdominal sacrocolpopexy and vaginal sacrospinous ligament fixation for severe uterovaginal or vault prolapse, assessing primary surgical outcomes at last follow-up. Ninety-seven women met inclusion criteria based on Halfway system grading (uterovaginal grade 4 or vault grade 3) and underwent either abdominal (n=113) or vaginal (n=64) procedures. Results show higher cure rates after abdominal surgery alongside increased intra- and postoperative morbidity; vaginal surgery shows more suture erosion, leading to a recommendation tailored to medical comorbidity.","O r i g i n a l A r t i c l e Singapore Med J 2004 Vol 45(10) : 475  \nComparison of effectiveness of vaginaland abdominal routes in treating severe uterovaginal or vault prolapse  \nC C M Ng, W H C Han  \nABSTRACT  \nIntroduction: This study compares the efficacy of abdominal and vaginal routes in correcting severe uterovaginal or vault prolapses by examining their primary surgical outcomes.  \nMethods: A retrospective study was conducted on operations performed from March 1998 to December 2001. The classifications of uterovaginal prolapse and vault prolapse were based on the Halfway system. It involved 177 women with at least grade 4 uterovaginal prolapse or grade 3 vault prolapse, and had undergone vaginal sacrospinous ligament fixation or abdominal sacrocolpopexy. The subjects were divided into two groups: 113 women who had an abdominal sacrocolpopexy and 64 women who had a vaginal sacrospinous ligament fixation. The primary surgical outcome measures was classified as cured, improved or failure according to our definition at their last follow-up.  \nResults: The abdominal sacrocolpopexy group had significantly greater intra-operative blood loss, operating time, haematuria, longer postoperative catheterisation and hospitalisation. Vaginal sac ros pi nous ligament fixation had more suture erosion. 95.6 percent of women with abdominal sacrocolpopexy were cured compared to 79.7 percent with vaginal sacrospinous ligament fixation. Five (4.4 percent) patients in the abdominal sacrocolpopexy group and six (9.4 percent) in the vaginal sac rospinous ligament fixation group defaulted their six-month follow-up with a mean follow-up of 18.1 months (range 0.9-48.1 months) and 13.2 months (range 1. 1-29. 1 months), respectively.  \nConclusion: Abdominal sacrocolpopexy is more effective in correcting severe uterovaginal or vault prolapses but it is associated with higher intraand post-operative morbidity compared to vaginal sacrospinous ligament fixation. Vaginal sacrospinous ligament fixation is preferred in patients with medical disorders.  \nKeywords: abdominal sacrocolpopexy, uterovaginal prolapse, vaginal sacrospinous ligament fixation, vault prolapse  \nSingapore MedJ 2004 Vol 45(10):475-481  \nINTRODUCTION  \nAbout 50% of parous women are estimated to have some form of pelvic organ prolapse, with 10% to 20% requesting treatment of their symptoms(1) . It is reported that 46.2% of women aged 15 to 97 years old experience or had experienced pelvic floor dysfunction(2) . Once prolapse has occurred, spontaneous recovery is not possible. The condition tends to deteriorate in menopause as atrophy results in further weakening of the supporting tissues. Surgery can be curative for pelvic organ prolapse.  \nRepair of pelvic support defects can be performed abdominally or vaginally(3-9). These range from partial(10) or total colpocleisis(11) and colpectomy(12) to the newer laparoscopic techniques (13,14) and, more recently, infracoccygeal sacropexy (posterior intravaginal slingplasty)(15,16) . The choice of surgery would depend on the patient’s symptoms and severity of pelvic floor prolapse. Before surgery, one must consider the patient’s age, fitness for operation, medical conditions, physical and sexual activities, previous operations and desire to retain the uterus. Women requiring pelvic floor reconstructive surgery often have more than one pelvic support defect at various vaginal sites(17) .  \nAlthough there have been many studies comparing abdominal versus vaginal route for the repair of pelvic support defects(18,19), none have been conducted in Singapore. This study aims to determine whether the vaginal or abdominal route is more effective in treating severe uterovaginal or vault prolapses, with abdominal sacrocolpopexy and vaginal sacrospinous ligament fixation as the main operations for comparison. The principles of pelvic floor reconstructive surgery are to correct pelvic support defects in order to restore normal pelvic anatomy and maintain f","cbCaijB3sr9a0d6X","https://ap.wps.com/l/cbCaijB3sr9a0d6X","pdf",141441,5,1,"English","en",105,"# Abstract\n# Introduction\n# Methods\n## Study design and participants\n## Surgical procedures","[{\"question\":\"What is the main objective of the study?\",\"answer\":\"To compare the effectiveness of abdominal versus vaginal surgical routes for correcting severe uterovaginal or vault prolapse, focusing on primary surgical outcomes.\"},{\"question\":\"How were patients grouped in the study?\",\"answer\":\"Women with severe uterovaginal prolapse or vault prolapse were allocated to either abdominal sacrocolpopexy (113 women) or vaginal sacrospinous ligament fixation (64 women).\"},{\"question\":\"Which procedure showed better cure outcomes and what trade-off was reported?\",\"answer\":\"Abdominal sacrocolpopexy produced higher cure rates (95.6%) than vaginal fixation (79.7%), but it was associated with greater intra- and postoperative morbidity, while vaginal fixation had more suture erosion.\"}]","Comparison of effectiveness of vaginal and abdominal routes in treating severe uterovaginal or vault prolapse - 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