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Long-term subjective, clinical and sonographic outcomes after native-tissue and mesh-augmented posterior colporrhaphy

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Abstract

Introduction and hypothesis

Our primary objective was to describe long-term outcomes after posterior colporrhaphy with and without mesh augmentation.

Methods

This was a retrospective study including 93 patients after posterior colporrhaphy (native tissue in 39 and synthetic mesh augmented in 54). The indication was symptoms of prolapse with clinical posterior vaginal wall prolapse. Mesh augmentation and concomitant prolapse operations were performed at the surgeon’s discretion. Patients underwent interview, clinical examination and 4D pelvic floor ultrasound. Imaging analysis was done with the reviewer blinded against all other data. Generalized linear modeling was used to compare groups with logistic regression for binary and linear regression for continuous outcomes.

Results

Patients were seen on average 5.3 years after surgery and described persistent symptoms of prolapse in 32% and of obstructed defecation in 33%. Clinical recurrence (Bp ≥ −1) was seen in 20%, while sonographic recurrence (rectal ampulla descent to ≥ 15 mm below the symphysis pubis) was noted in 12%. A true rectocele was diagnosed in 33% of patients. No major differences in outcomes were found between those who underwent native tissue and those who had a mesh-augmented repair.

Conclusions

Mesh augmentation was not superior to native tissue posterior colporrhaphy, and both were only moderately effective in eliminating a true rectocele and symptoms of obstructed defecation 5 years after reconstructive surgery.

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Authors and Affiliations

  1. Sydney Medical School Nepean, Nepean Hospital, Penrith, NSW, 2750, Australia

    Moshe Gillor, Susanne Langer & Hans Peter Dietz

  2. Kaplan Medical Center, Affiliated to the Hebrew University and Hadassah School of Medicine in Jerusalem, Rehovot, Israel

    Moshe Gillor

Authors
  1. Moshe Gillor
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  2. Susanne Langer
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  3. Hans Peter Dietz
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Corresponding author

Correspondence to Moshe Gillor.

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Conflicts of interest

H.P. Dietz has received lecture honoraria and travel assistance from GE Medical. The other authors have no conflicts of interest to declare.

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Gillor, M., Langer, S. & Dietz, H.P. Long-term subjective, clinical and sonographic outcomes after native-tissue and mesh-augmented posterior colporrhaphy. Int Urogynecol J 30, 1581–1585 (2019). https://doi.org/10.1007/s00192-019-03921-0

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  • DOI: https://doi.org/10.1007/s00192-019-03921-0

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