Analysis of the outcomes of pelvic floor repair surgery using POP-Q classification

Abstract

Background: In Mongolia, research on pelvic organ prolapse and female urinary incontinence is being conducted, but it is rare, regardless of the type of disease, focusing only on the problem of surgical treatment and improvement of surgical methods, and the results of surgical treatment are not considered sufÏciently. Therefore, evaluation of pelvic muscle prolapse by POP-Q assessment, one of the main causes of pelvic organ prolapse and urinary incontinence, is important for evaluating treatment results, which is why this study is conducted. Aim: Evaluation of outcomes after reconstructive surgery for pelvic organ prolapse using the POP-Q international scoring system Materials and Methods: We analyzed 79 patients with pelvic organ prolapse treated with anterior and posterior colporrhapy surgery in the gynecological surgery department between January 2023 and June 2024. Descriptive statistics were used to summarise the women’s demographics and perioperative clinical data including Patients’ age, symptoms, pregnancy, number of births, body mass index, and working conditions with 40 questionaries. The Chi-squared or two-sided Fisher’s exact test was used to compare categorical variables. The pre-and post-operative POP-Q assessment was compared using the Wilcoxon signed-rank test and Multivariate test, A P-value of <0.05 was considered statistically significant. Results: The mean age of the women was 46.5 ± 7.3 (32–72). The average pregnancy of women was 4.8±5.3 ( 2–10), the average birth was 3.4±2.3 (2–10) and the average weight of the child was 3200g ±300. The average BMI is 27.04±4.2 (23.2-33.7). Conditions of employment 21 (35%) standing work, 15 (25%) sitting work, 24 (40%) moderate mobility. There was a significant improvement in all three compartments after the operation and the total vaginal length was preserved (p-value<0.05). Among them, 35 (60%) of all women or 30-50 years old POP-Q assessment after surgery: grade 0-I: Aa, Ap, Ba, Bp -3 and C or D&lt; (tvl-2) cm is 22 (37.4%) or above 50 years of age, grade II – Descending edge &gt;-1 but &lt;+1. Conclusions: 1. The surgical method of pelvic muscle rehabilitation is not only one of the effective treatment methods, but it was also found to be one of the suitable evaluation methods to evaluate the results of the surgical treatment by evaluating the degree of sagging and the reduction of all muscle dimensions when calculating the results of the surgical treatment. 2. Women’s age, BMI, and the increase in the number of births have the effect of reducing the results after pelvic muscle reconstruction surgery. Therefore, a long-term follow-up study is needed.