Use of titanium implants in the surgical treatment of complete uterine or vaginal prolapse in elderly and senile patients after hysterectomy

BACKGROUND: With increasing life expectancy, the need to improve the quality of life in elderly and senile women has become more urgent. Pelvic organ prolapse is a significant concern, particularly because this pathology tends to progress in the postmenopausal period. Surgical treatment of pelvic organ prolapse using only the patient’s own tissues often results in recurrence of the disease. This highlights the need for developing new surgical techniques that utilize durable and biologically inert materials, such as titanium implants. AIM: The objective of this study is to analyze the effectiveness and reliability of surgical correction of complete uterine or vaginal prolapse after hysterectomy in elderly and senile women. MATERIAL AND METHODS: A total of 65 women, aged between 65 and 86 years old, were examined and underwent surgery using two newly developed original surgical techniques. Group I (31 patients) underwent surgery with the use of a titanium mesh implant, while Group II (34 patients) underwent surgery with the use of a combination of the aforementioned mesh implant with two non-absorbable ligatures. RESULTS: The outpatient follow-up was carried out on Months 1, 6, 12, 24, 36 and 48 after surgery. The comprehensive examination, comprising questionnaires, gynecological examination and transperineal post-surgery ultrasound, demonstrated that the surgical treatment was satisfactory, as evidenced by an improvement in the women's quality of life. During Month 1 after the surgery, 32 patients (49.2%) reported intermittent perineal pain and/or aches in the area of the inguinal folds, while 15 patients (65.0%) experienced frequent attempts to urinate. These symptoms abated with time. No recurrences of the disease or mesh-associated complications were recorded during the follow-up period. CONCLUSION: The study demonstrates the efficacy and reliability of newly developed surgical techniques for treating complete uterine and vaginal prolapse after hysterectomy in elderly and senile women. The accumulated clinical experience attests to the fact that severe pelvic organ prolapse in elderly patients with concomitant somatic diseases can be successfully treated via surgical intervention. This has the potential to relieve women from the range of symptoms associated with the disease and normalize the functioning of pelvic organs. The introduction of such surgeries into clinical practice will improve the quality of life of elderly and senile patients.