ИСХОДЫ ОПЕРАТИВНОГО ЛЕЧЕНИЯ НЕДОСТАТОЧНОСТИ МЫШЦ ТАЗОВОГО ДНА 3 СТЕПЕНИ У ЖЕНЩИН ПОЖИЛОГО ВОЗРАСТА: УДК 618.18-08

Research objective. To evaluate the outcomes of surgical treatment of degree 3 pelvic floor muscle failure in elderly women.Materials and methods. 86 elderly women (60 to 75 years old) suffering from degree 3 pelvic floor muscle failure (PFMF) were sampled and divided into two groups. In group J (n=56), patients received surgical treatment: correction of prolapse by the reticulate implant through transvaginal access with transobturator fixation, levatoroplasty.In group H (n=30), patients refused surgical treatment. Efficiency evaluation was carried out 12 months later: explicit and latent urinary incontinence at tension was detected with a cough test and a Valsalva test; the intensity of complaints was measured by the NRS scale; a quality of life was assessed through the PFDI-20 questionnaire.The frequency of clinical symptoms of PFMF after 12 months was assessed as the primary outcome of surgical treatment; the frequency of latent and explicit urinary incontinence and the quality of life through the PFDI-20 questionnaire 12 months after treatment were studied as secondary outcomes.Results. 12 months after treatment, group J patients experienced a statistically significant decrease in the frequency and intensity of complaints and PFMF symptoms. POPDI indicators in group J were better 12 months after treatment and amounted to 8.3 (4.2;12.5) points in group J and 79.2 (79.2;100) in group H, U[ 56;30]=2145, p=0.001; CRAD-8 indicators were 6.2 (3.1;6.2) in group J and 68.8 (62.5;71.9) in group H, U[56;30]=1967, p=0.742; UDI-6 indicators were 8.3 (4.2;8.3) in group J and 83.3 (79.2;87.5) in group H, U[56;30]=2145, p=0.001. The total PFDI-20 was 22.8 (11.5;27) points in group J and 227.2 (226.1;251) points in group H, U[56;30]=2155, p=0.001.Conclusion. Surgical correction of prolapse with the use of reticulate implants is an effective treatment of degree 3 PFMF in elderly women.