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Evaluation of three different surgical approaches in repairing paravaginal support defects: a comparative trial

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

Paravaginal defects have been shown to account for 60–80 % of anterior compartment prolapse and its repair offers the chance of a more effective cure of such defect. There is no good evidence to suggest the superiority of a particular route of paravaginal repair. The objective of this study was to evaluate the effectiveness of abdominal (APVR), vaginal (VPVR) and laparoscopic (LPVR) approaches in the repair of such defects.

Study design

This is a prospective comparative study of patients, referred over a 2-year period, with symptomatic stage II–IV anterior compartment prolapse due to paravaginal support defects. Patients were assessed subjectively by direct verbal questioning, and objectively, using POP-Q system for staging, at 1, 6 and 12 months postoperatively. Analysis of data was performed using SPSS for Windows (V9) software package.

Results

Forty-five patients were recruited to the study. There was no significant difference in the subjective and objective outcomes of APVR (n = 20) and VPVR (n = 20) groups. The laparoscopic approach had to be abandoned after five patients only, as the degree of improvement in prolapse stage was less than in the other two approaches.

Conclusion

The effectiveness of paravaginal repair procedure is similar whether the abdominal or vaginal approaches were adopted in patients with anterior compartment prolapse due to paravaginal support defects. In our experience, the laparoscopic approach was associated with the least favourable outcome.

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Acknowledgments

The authors wish to acknowledge the support of the staff and the patients of Ain Shams University Urogynaecology and Pelvic Reconstructive Surgery Clinic. This work was funded from Ain Shams University Urogynaecology and pelvic reconstructive surgery unit.

Ethical standard

The study was approved by Ain Shams University Hospitals ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Ain Shams University, Abbassia Square, Cairo, Egypt

    Mohamed M. Hosni, Alaa E. H. El-Feky & Essam M. Khater

  2. NHS Ayrshire and Arran, Kilmarnock, UK

    Wael I. Agur

Authors
  1. Mohamed M. Hosni
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  2. Alaa E. H. El-Feky
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  3. Wael I. Agur
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  4. Essam M. Khater
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Correspondence to Mohamed M. Hosni.

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Hosni, M.M., El-Feky, A.E.H., Agur, W.I. et al. Evaluation of three different surgical approaches in repairing paravaginal support defects: a comparative trial. Arch Gynecol Obstet 288, 1341–1348 (2013). https://doi.org/10.1007/s00404-013-2927-4

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  • DOI: https://doi.org/10.1007/s00404-013-2927-4

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