Change in intraabdominal pressure after pelvic organ prolapse reconstructive surgery in elderly women

Abstract

Introduction: Intraabdominal pressure (IAP) was defined as the steady-state pressure concealed within the abdominal cavity. Sustained increase in IAP has become the focus of attention in many disciplines, which has an impact on pulmonary and cardiovascular systems. Levator hiatus is the opening of this closed abdominal box to atmosphere. Pelvic organ prolapse (POP) 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 elderly patients with severe uterovaginal prolapse on intraabdominal pressure. Material and Methods: This is a cross-sectional, case-control study comparing preoperative and postoperative IAPs in women with advanced symptomatic stage >= 3 uterovaginal prolapse. IAP was measured in 13 women, before and 6 months after laparoscopic sacrocolpopexy and in 13 controls. 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 of 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 POP and its clinical consequences should be evaluated with large, well designed studies.