Abstract
Introduction and hypothesis
We sought to compare rates of recurrent cystocele following sacrocolpopexy with and without paravaginal repair (PVR).
Methods
This retrospective cohort study compared outcomes for patients undergoing sacrocolpopexy with (group A) and without (group B) concomitant PVR. Defining anterior failure as point Ba ≥ −1 cm, we compared anatomic outcomes and reoperation rates for recurrence of cystocele.
Results
One hundred seventy patients undergoing sacrocolpopexy had anterior wall prolapse at or beyond the hymen before surgery (62 in group A and 108 in group B). Ten (16.1%) patients in group A and 29 (26.9%) in group B experienced anterior wall prolapse to or beyond −1 cm (p = 0.13, power 0.38). Among these groups, one (1.6%) and five (4.6%) underwent reoperation for cystocele recurrence (p = 0.42, power <0.3).
Conclusions
Despite the trend toward improved clinical outcomes, we were unable to detect a statistically significant difference with inclusion of PVR with sacrocolpopexy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- PVR:
-
Paravaginal repair
- POPQ:
-
Pelvic organ prolapse quantification
- ICS:
-
International Continence Society
References
DeLancey JO (1992) Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 166:1717–1724
Nygaard IE, McCreery R, Brubaker L, Connolly A, Cundiff G, Weber AM et al (2004) Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 104:805–823
Richardson AC, Lyon JB, Williams NL (1976) A new look at pelvic relaxation. Am J Obstet Gynecol 126:568–573
Richardson AC, Edmonds PB, Williams NL (1981) Treatment of stress urinary incontinence due to paravaginal fascial defect. Obstet Gynecol 57:357–362
Lowder JL, Park AJ, Ellison R, Ghetti C, Moalli P, Zyczynski H et al (2008) The role of apical vaginal support in the appearance of anterior and posterior vaginal prolapse. Obstet Gynecol 111:152–157
Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17
Weber AM, Abrams P, Brubaker L, Cundiff G, Davis G, Dmochowski RR et al (2001) The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct 12:178–186
Yang JM, Yang SH, Huang WC (2005) Dynamic morphological changes in the anterior vaginal wall before and after laparoscopic Burch colposuspension in primary urodynamic stress incontinence. Ultrasound Obstet Gynecol 25:289–295
Rooney K, Kenton K, Mueller ER, FitzGerald MP, Brubaker L (2006) Advanced anterior vaginal wall prolapse is highly correlated with apical prolapse. Am J Obstet Gynecol 195:1837–1840
Chen L, Ashton-Miller JA, DeLancey JO (2009) A 3D finite element model of anterior vaginal wall support to evaluate mechanisms underlying cystocele formation. J Biomech 42:1371–1377
Quiroz LH, Gutman RE, Shippey S, Cundiff GW, Sanses T, Blomquist JL et al (2008) Abdominal sacrocolpopexy: anatomic outcomes and complications with pelvicol, autologous and synthetic graft materials. Am J Obstet Gynecol 198(557):e1–5
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shippey, S.H., Quiroz, L.H., Sanses, T.V.D. et al. Anatomic outcomes of abdominal sacrocolpopexy with or without paravaginal repair. Int Urogynecol J 21, 279–283 (2010). https://doi.org/10.1007/s00192-009-1013-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-009-1013-8