А method of surgical correction of genital prolapse in combination with elongation and cicatricial deformation of the cervix in patients of reproductive age. A retrospective study

Aim. To improve reproductive health and quality of life of patients with genital prolapse combined with elongation, cicatricial deformation of the cervix. Materials and methods. The study included 43 patients with genital prolapse of grades I–II according to the POP-Q classification in combination with elongation and cicatricial deformation of the cervix. All of them underwent surgery – plastic surgery of the cervix using the Yeltsov–Strelkov stratification method in combination with reconstruction of levels II and III of pelvic floor support according to DeLancey. Results. The results of surgical treatment were assessed after 1–6 years. Overactive bladder was diagnosed before surgery in 4 (9.3%) people, after – in 2 (4.7%); p0.05. In this case, an increase in the maximum flow rate and a decrease in the volume of residual urine were observed (p0.05). In 41 (95.3%) patients, improvements were found in all parts of the vagina in the postoperative period. They were satisfied with the treatment according to the results of the PFDI-20 questionnaire. Recurrence of genital prolapse in the form of prolapse of the posterior vaginal wall was detected in 2 (4.6%) women. Pregnancy occurred in 8 people: in 3 (7.0%), it ended in timely delivery by cesarean section according to the sum of relative indications; in 2 (4.6%), medical terminations of pregnancy were performed; in 1 (2.3%) – surgical abortion. The remaining 36 (83.7%) protected themselves from pregnancy throughout the observation period. Conclusion. Surgical treatment in the volume of plastic surgery of the cervix by the method of stratification and reconstruction of II and III levels of pelvic floor support according to DeLancey in case of genital prolapse of I–II degree according to the POP-Q classification in combination with cicatricial deformation and elongation of the cervix made it possible to restore the topography of the pelvic organs and their functions. This method of surgical treatment makes it possible to recreate the anatomy of the cervix with native tissues without its amputation. It has no unfavorable obstetric outcomes and can be used in women interested in reproductive function.