E-Posters-Surgical Management of Pelvic Organ Prolapse in Ethiopian Women

Surgical Management of Pelvic Organ Prolapse in Ethiopian Women - Kimberly Kenne, MD, MCR

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The objective of this study was to determine the most effective surgical repair of pelvic organ prolapse (POP) for rural Ethiopian women and to better understand this population. POP affects many women worldwide, and it is possible that it has a greater impact on women in low-income countries due to factors such as more pregnancies, physical strain, and less access to obstetric care.<br /><br />A prospective cohort study was conducted comparing surgical outcomes between women who had POP repair abdominally with synthetic mesh augmentation and those who had POP repair vaginally with native tissue. Data on demographics, symptoms, anatomic assessments of POP, and surgical details were collected. Follow-up data on complications and symptomatic and anatomic measures were also collected.<br /><br />Of the 233 women who underwent surgical prolapse repair, 70 had abdominal mesh augmented repair and 163 had vaginal native tissue repair. In the study, 78 women participated with a median follow-up of 255 days. Anatomic failure was observed in 34% of women who had vaginal repair compared to 0% of women who had sacrocolpopexy. Symptomatic failure, or recurrence of vaginal bulge, was reported by 23% of women who had vaginal repair compared to 0% of women who had sacrocolpopexy. The majority of women who underwent sacrocolpopexy reported improvement, while the majority of women who had vaginal repair reported improvement or no change.<br /><br />There were two intraoperative complications and three postoperative complications, but no cases of mesh erosion were reported.<br /><br />Based on the findings, the study suggests that an abdominal approach with mesh augmentation may be the preferred surgical repair for POP in rural Ethiopian women. This information can help improve surgical management and outcomes for women with POP in low-income settings.

Keywords

surgical repair

pelvic organ prolapse

rural Ethiopian women

POP

low-income countries

abdominal mesh augmentation

vaginal native tissue repair

anatomic failure

symptomatic failure

sacrocolpopexy