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Nine-year objective and subjective follow-up of the ultra-lateral anterior repair for cystocele

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Abstract

Introduction and hypothesis

The aim of this study was to determine the long-term objective and subjective outcomes of the native tissue ultra-lateral anterior repair for cystocele.

Methods

An observational study of patients from a single tertiary centre was carried out from January 1994 to December 2006. Patients who underwent an ultra-lateral anterior repair during this period were sent the Pelvic Floor Distress Inventory (PFDI) questionnaire and invited to return for a POP-Q examination. Symptoms of prolapse, stage of cystocele recurrence and reoperation rate were assessed at follow-up.

Results

Of the 135 patients recruited, 53 also had a POP-Q examination. Mean follow-up was 9.25 years (SD 3.2). The anatomical recurrence rate was 45 % at 9.25 years, but only 26 % of patients had recurrent prolapse symptoms. Most recurrences (43 %) occurred at between 1 and 5 years. The reoperation rate for cystocele was 7.4 %.

Conclusion

Despite these rates of anatomical and symptomatic recurrence, only 7.4 % of patients underwent repeat cystocele surgery. Thus, symptomatic/anatomical recurrence of prolapse often does not mandate surgical correction. Considering that mesh complications require surgical management in approximately 10–15 %, this study supports the notion that the use of mesh in anterior vaginal repairs to reduce the risk of “recurrence” needs careful discussion with each patient.

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Abbreviations

PFDI:

Pelvic Floor Distress Inventory

POP-Q:

Pelvic organ prolapse quantification

TVT:

Tension-free vaginal tape

SSF:

Sacrospinous fixation

References

  1. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506

    Article  CAS  PubMed  Google Scholar 

  2. Nieminen K, Hiltunen R, Takala T et al (2010) Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up. Am J Obstet Gynecol 203:235.e231–235.e238

    Google Scholar 

  3. Altman D, Väyrynen T, Engh ME, Axelsen S, Falconer C (2011) Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med 364:1826–1836

    Article  CAS  PubMed  Google Scholar 

  4. Kapoor DS, Nemcova M, Pantazis K et al (2010) Reoperation rate for traditional anterior vaginal repair: analysis of 207 cases with a median 4-year follow-up. Int Urogynecol J 21:27–31

    Article  PubMed  Google Scholar 

  5. Miedel A, Tegerstedt G, Mörlin B, Hammarström M (2008) A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse. Int Urogynecol J 19:1593–1601

    Article  Google Scholar 

  6. Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1304, discussion 1304–1296

    Article  CAS  PubMed  Google Scholar 

  7. Jones HW, Rock JA (2010) Te Linde’s operative gynecology, 10th edn. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  8. Nichols DH, Randall CL (1989) Vaginal surgery, 3rd edn. Lippincott Williams & Wilkins, Baltimore, pp 247–268

    Google Scholar 

  9. Chmielewski L, Walters MD, Weber AM, Barber MD (2011) Reanalysis of a randomized trial of 3 techniques of anterior colporrhaphy using clinically relevant definitions of success. Am J Obstet Gynecol 205:69.e61–69.e68

    Google Scholar 

  10. Barber MD, Walters MD, Bump RC (2005) Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 193:103–113

    Article  CAS  PubMed  Google Scholar 

  11. Iglesia CB, Sokol AI, Sokol ER et al (2010) Vaginal mesh for prolapse: a randomized controlled trial. Obstet Gynecol 116:293–303

    Article  PubMed  Google Scholar 

  12. Hendrix S, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A (2002) Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol 186:1160–1166

    Article  PubMed  Google Scholar 

  13. Weemhoff M, Vergeldt TF, Notten K, Serroyen J, Kampschoer PH, Roumen FJ (2012) Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study. Int Urogynecol J 23(1):65–71

    Article  PubMed Central  PubMed  Google Scholar 

  14. Maher C, Feiner B, Baessler B et al (2010) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev CD004014

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Authors and Affiliations

  1. Department of Urogynecology, St George Hospital, University of New South Wales, Kogarah, Sydney, NSW, Australia, 2217

    Zhuoran Chen, Vivien Wong & Kate H. Moore

  2. Statistician, National Perinatal Statistics Unit, School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia

    Alex Wang

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  1. Zhuoran Chen
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  2. Vivien Wong
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  3. Alex Wang
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  4. Kate H. Moore
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Correspondence to Zhuoran Chen.

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Chen, Z., Wong, V., Wang, A. et al. Nine-year objective and subjective follow-up of the ultra-lateral anterior repair for cystocele. Int Urogynecol J 25, 387–392 (2014). https://doi.org/10.1007/s00192-013-2234-4

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  • DOI: https://doi.org/10.1007/s00192-013-2234-4

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