Results
A total of 52 sets of IAP measurements were conducted in 26 women: 13 in the prolapse group and 13 in the control D&C group. Thirteen women with stage 3 or utero-vaginal prolapse 4 according to the POP-Q system underwent the sacrocolpopexy procedure. The demographics and IAP measurements of each group are shown in Table 1. As a result of matching, there was no significant difference in age and BMI between both groups. The mean age was 62 ± 10.7 years (range 43-76) in the prolapse group and 61.5 ± 10.1 years (range 44-75) in control group. The mean BMI was 26.4 ± 2.3 (range 22.6-30) in the prolapse group and 27.9 ± 2.2 (range 23-32) in the control group. The waist circumferences were similar between the prolapse (104.2 ± 8.9) and control (102.5 ± 9.1) groups. The median gravida was significantly higher in the prolapse group (median 4 (range 2-6)) than in the control group (median 3 (1-4), p=0.006). The median parity was 3 (2-6) in the prolapse group and 2 (1-4) in the controls (p=0.5).
The mean preoperative IAP was 5.6 ± 2.4 mm Hg (range 2-11 mm Hg) in the prolapse group. The mean preoperative IAP of controls (4.5 ± 1 mm Hg (range 3-6 mm Hg) was not significantly different than in women with stage ≥3 uterovaginal prolapse (p=0.1). Preoperative IAP of 4 (53.8%) women with prolapse was over 7 mmHg (p=0.03). The mean postoperative IAP at the 6 month control examination was 8.6 ±2.5 mmHg (range 6-14 mmHg) and significantly higher than the postprocedure IAP of the control group (4.8 ± 1.1 mmHg (range 3-7 mmHg) (p<0.0001). Figure 1 shows the intra-abdominal pressure variations pre- and postoperatively. The mean IAP was significantly higher at 6 months after pelvic reconstructive surgery than before surgery (p=0.001). The alteration of IAP in the control group was statistically insignificant (p=0.3). The IAP of seven (53.8%) patients was over 7 mmHg (p=0.03), and 2 of 13 (15.3%) had IAH (p=0.1).
In the correlation analysis of preoperative and postoperative IAP with age, BMI, weight, height, gravidy and parity of women, postoperative IAP in the prolapse group was significantly correlated with gravidy (r = 0.65, P < 0.01) and parity (r = 0.87, P < 0.001). Age, BMI, weight, height and waist circumference were not correlated with either preoperative or postoperative IAP measurements.