Implications of surgical, hormonal and obstetric factors in the pathophysiology of pelvic floor disorders prolapse. Results on 103 cases operated with the Saba Nahedd technique

O.C. Ionescu, N. Bacalbașa, N. Saba, G. Bănceanu

Abstract: The prolapse of the pelvic organs is a pathologic condition that results from the deterioration of the support system of the pelvic organs. This system consists of pelvis structures which are organized on three levels of support whose deterioration cause apical and/or anterior and/or posterior compartment prolapse. The purpose of this article is to present the implications of different risk factors in the pathophysiology of pelvic floor disorders (PFD) on 103 women with symptomatic POP who have been operated with the surgical technique developed by Saba Nahedd. Our 103 cases have been examined and operated between 2013 and 2018. We have enrolled women aged between 31 and 81 years with symptomatic uterine prolapse grade I-IV and/or cystocele per magna and/or rectocele. All the 103 were preoperatively investigated through clinical examination, blood and urine test, colposcopy, cervical cytology (Pap Test), fractionated curettage, ultrasound and cystography. For all of the patients has been applied the surgical technique of attaching the uterine isthmus to the sheath of the rectus abdominis muscle using an isthmus strip. The results showed that surgical intervention in the pelvic area, traumatic deliveries with forceps application and menopause are associated with an increased risk of apical prolapse stage II, cystocele per magna and rectocele. Our study showed that conjunctive tissue is the central part of the integral theory developed by Petros who showed that destruction of the conjunctive tissues in the pelvic fascia and ligaments is responsible for the PFD.
DOI:10.18643/gieu.2018.15

Keywords: apical prolapse, cystocele, rectocele, prolapse of the pelvic organs.