this study designed To evaluate the efficacy and outcomes of laparoscopic approach for repair of paravaginal defects associated with anterior vaginal wall prolapse.
This prospective interventional study. designed to evaluate the efficacy and outcomes of laparoscopic approach for repair of paravaginal defects associated with anterior vaginal wall prolapse .fifty participants with cystocele of lateral type offered laparoscopic paravaginal repair. the investigator used a 10mm laparoscope, with video camera, was introduced through the umbilical trocar. Another 5 mm in suprapubic area and two 10 mm trocars in right and left lateral abdominal sides were introduced. The larger trocar was needed to accommodate the passage of needles into the abdomen. Spacing of trocars sufficiently from each other was needed to facilitate laparoscopic suturing. Transperitoneal approach to retropubic space was used. Two to four polypropylene sutures were applied on each side. Sutures were tied with intracorporeal . The study evaluated the following outcomes Operative time, intra-operative blood loss, hospital stay , post-operative urinary symptoms, post-operative pain, fever, haematuria, post-operative vaginal wall prolapse .
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Using a 10mm laparoscope, with video camera, was introduced through the umbilical trocar. Another 5 mm in suprapubic area and two 10 mm trocars in right and left lateral abdominal sides were introduced. The larger trocar was needed to accommodate the passage of needles into the abdomen. Spacing of trocars sufficiently from each other was needed to facilitate laparoscopic suturing. Transperitoneal approach to retropubic space was used. Two to four polypropylene sutures were applied on each side. Sutures were tied with intracorporeal technique
operative time
time needed for the procedure to be completed
Time frame: insertion of the primary tracer ( umbilical trocar )-during the procedure - ends with removing camera telescope
intraoperative blood loss
amount of bleeding during the procedure
Time frame: start with dissection or retropubic space - during the procedure -ends with removing the camera telescope at the end of operation
post-operative pain: Faces Pain Scale
assessment of pain using Faces Pain Scale( displaying faces that show how much pain the participant can feel. starting with the face on far left shows no pain as The faces move to the right show more and more pain that ends with the face on the right which shows the worst pain then the participants Point to the face that shows how much they feel pain , Each face has a score 0, 2, 4, 6, 8, or 10, so score "0" = "no pain" and score "10" = "very much pain).
Time frame: start after patient recovery from anaesthesia - ends after 12 hours
post-operative hematuria
visible red or brown discoloration of urine .
Time frame: starts observation of urine 1hour after end of operation - ends 24 hours after the starting observation
hospital stay
hours needed to keep the patient in hospital post operative
Time frame: during hospitalization
fever
body temperature 38 Celsius or above
Time frame: starts after shifting the patient from the recovery room to inpatient ward - end 24 hours after shifting the patient
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post-operative vaginal wall prolapse
assessment of the anterior vaginal wall using:Pelvic Organ Prolapse Quantification System .
Time frame: starts one week following the procedure - three months after the procedure - six months after the procedure -ends one year after the procedure
post-operative abnormal urinary symptoms
abnormal urinary symptoms: ( inability to urinate voluntary- pain during micturition - involuntary escape of urine )
Time frame: starts one week following the procedure - three months after the procedure - six months after the procedure -ends one year after the procedure