A Prospective Study of Minimally Invasive Paravaginal Repair of Cystocele and Associated Pelvic Floor Defects: Our Experience

  • Kavitha Yogini DuraisamyEmail author
  • Devi Balasubramaniam
  • Amrutha Kakollu
  • Palanivelu Chinnusamy
  • Kodeeswari Periyasamy
Original Article


Aims and objectives

To assess the outcome of minimally invasive paravaginal repair of symptomatic cystocele and to correlate postoperative outcome with preoperative presentation. The primary outcome was the anatomical outcome measured by postoperative physical examination and the functional outcome was assessed by subjective symptoms and questionnaires. The secondary outcomes were perioperative and postoperative complications.

Materials and methods

In this longitudinal prospective observational study, 44 women underwent laparoscopic or robotic paravaginal cystocele repair from January 2016 to July 2016 and they were followed up to 1 year after surgery in a tertiary advanced laparoscopic center. All patients had a symptomatic lateral cystocele ≥ grade 2 according to Baden–Walker classification. Other coexisting defects like apical cystocele or combined defects were corrected concomitantly. The anatomical outcome was measured by physical examination and functional outcome was assessed by questionnaires—Pelvic Organ Prolapse Distress Inventory 6 and Urinary Distress Inventory 6 preoperatively and during postoperative follow-up.


All 44 patients were followed up to 12 months after surgery. The anatomical cure rate for cystocele was 97.7%. There were no major complications. All subjective symptoms and quality of life scores improved significantly during postoperative follow-up. The anatomical recurrence rate in our study was 2.3%.


Minimally invasive paravaginal repair of cystocele is an effective advanced laparoscopic procedure. It can be concomitantly performed with other surgical procedures to correct coexisting defects. The anatomical and functional results were outstanding with minimum perioperative morbidity and encouraging long-term outcome.


Laparoscopy Robotic Paravaginal repair Cystocele Prolapse 


Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Price N, Jackson SR. Advances in laparoscopic techniques in pelvic reconstructive surgery for prolapse and incontinence. Maturitas. 2009;62(3):276–80.CrossRefGoogle Scholar
  2. 2.
    Choi KH, Hong JY. Management of pelvic organ prolapse. Korean J Urol. 2014;55(11):693–702.CrossRefGoogle Scholar
  3. 3.
    Brubaker L, Maher C, Jacquetin B, et al. Surgery for pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2010;16(1):9–19.CrossRefGoogle Scholar
  4. 4.
    Ghoniem G, Stanford E, Kenton K, et al. Evaluation and outcome measures in the treatment of female urinary stress incontinence: International Urogynecological Association (IUGA) guidelines for research and clinical practice. Int Urogynecol J. 2008;19(1):5–33.CrossRefGoogle Scholar
  5. 5.
    Bedford ND, Seman EI, O’shea RT, et al. Long-term outcomes of laparoscopic repair of cystocoele. Aust N Z J Obstet Gynaecol. 2015;55(6):588–92.CrossRefGoogle Scholar
  6. 6.
    Ganatra AM, Rozet F, Sanchez-Salas R, et al. The current status of laparoscopic sacrocolpopexy: a review. Eur Urol. 2009;55(5):1089–105.CrossRefGoogle Scholar
  7. 7.
    Kdous M, Zhioua F. 3-year results of transvaginal cystocele repair with transobturator four-arm mesh: a prospective study of 105 patients. Arab J Urol. 2014;12(4):275–84.CrossRefGoogle Scholar
  8. 8.
    Rosen DM, Shukla A, Cario GM, et al. Is hysterectomy necessary for laparoscopic pelvic floor repair? A prospective study. J Minim Invasive Gynecol. 2008;15(6):729–34.CrossRefGoogle Scholar
  9. 9.
    Devaseelan P, Fogarty P. The role of synthetic mesh in the treatment of pelvic organ prolapse. Obstet Gynaecol. 2009;11(3):169–76.Google Scholar
  10. 10.
    Persu C, Chapple CR, Cauni V, et al. Pelvic organ prolapse quantification system (POP–Q)–a new era in pelvic prolapse staging. J Med Life. 2011;4(1):75.Google Scholar

Copyright information

© Federation of Obstetric & Gynecological Societies of India 2018

Authors and Affiliations

  • Kavitha Yogini Duraisamy
    • 1
    Email author
  • Devi Balasubramaniam
    • 1
  • Amrutha Kakollu
    • 1
  • Palanivelu Chinnusamy
    • 1
  • Kodeeswari Periyasamy
    • 1
  1. 1.Department of EndogynecologyGem Hospital and Research CentreCoimbatoreIndia

Personalised recommendations