Pilot Study of Change in Intraabdominal Pressure after Pelvic Organ
Prolapse Reconstructive Surgery for Uterovaginal Prolapse
Abstract
Objective: Intra-abdominal pressure (IAP) was defined as the steady
state pressure concealed within the abdominal cavity. Sustained
increased in IAP has become the focus of attention in many disciplines
which is has impact on pulmonary, cardiovascular systems. Pelvic organ
prolapse might be the consequences of compensation of abdominal
compliance to increased IAP. The aim of this study was to evaluate the
effect of laparoscopic sacrocolpopexy in patients with severe
uterovaginal prolapse on intraabdominal presurre. Design: Prospective,
case control study Setting: Tertiary Urogynecology Unit Population:
Women with advanced symptomatic stage ≥3 uterovaginal prolapse. Method:
IAPs were measured in 13 women, before and 6 month after laparoscopic
sacrocolpopexy and in 13 controls. Main Outcome Measure: Preoperative
and postoperative IAP. Results: The mean preoperative IAP of controls
(4.5 ± 1 mmHg) was not significantly different than to women with stage
≥3 uterovaginal prolapse (p=0.1). The mean postoperative IAP at 6 months
control was 8.6 ±2.5 mmHg and significantly higher than postprocedure
IAP of control group (4.8 ± 1.1 mmHg) (p<0.0001). IAP of
prolapse group was significantly correlated with gravidy (r = 0.65, P
< 0.01) and parity (r = 0.87, P < 0.001).
Conclusions: IAP significantly increases after pelvic reconstructive
surgery in our pilot study. The association of increased IAP with pelvic
organ prolapse and its clinical consequences should be evaluated with
large, well designed, with studies