Skip to main content

Advertisement

SpringerLink
Log in

Cystocele Repair with Platelet-Rich Plasma

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Cystocele is the most common vaginal wall prolapse with high incidence of recurrence after operation. Our aim in this study was to show the effectiveness of using platelet-rich plasma with cystocele repair. Patients were assigned to 2 groups: (1) cystocele repair only and (2) cystocele repair with platelet-rich plasma injection. Each group consisted of 28 patients. There were no significant differences between the groups in terms of demographics features. They were re-assessed 4 weeks later, 6 months later and annually with the standard Pelvic Organ Prolapse Quantification system to detect anatomic recurrence, the Pelvic Floor Distress Inventory for assessment of symptomatic recurrence and Patient Impression of Global Improvement questionnaire for assessment of subjective success. At the end of the 48-month follow-up period, the results were compared between the groups. The main outcome was low recurrence rate with platelet-rich plasma administration and secondary outcome was lower Pelvic Floor Distress Inventory scale score and higher Patient Impression of Global Improvement questionnaire results. The decrease in prolapse symptoms ascertained with the Pelvic Floor Distress Inventory scale was more significant in group 2 (6 vs. 2, p = 0.002), reoperation rate for symptomatic cystocele recurrence was significantly lower in group 2 (5 (17.8%) vs. 1 (3.5%), p = 0.001) and also subjective success evaluated with Patient Impression of Global Improvement scale was significantly higher in group 2 (21 vs. 25, p = 0.012). Considering mesh complications, platelet-rich plasma administration may be a good alternative to prevent cystocele recurrence. However, further research is needed to evaluate the safety and efficacy of this treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

EGF:

Epidermal growth factor

FDA:

Food and Drug Administration

IGF-1:

Insulin-like growth factor-1

PDGF:

Platelet-derived growth factor

PGI-I:

Patient Impression of Global Improvement

PRP:

Platelet-rich plasma

POP:

Pelvic organ prolapse

POP-Q:

Pelvic Organ Prolapse Quantification

PFDI:

Pelvic Floor Distress Inventory

TGF:

Transforming growth factor

VEGF:

Vascular endothelial growth factor

References

  1. Olsen AL, Smith VJ, Bergstrom JO et al (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89(4):501–506

    Article  CAS  Google Scholar 

  2. Dawood AS, Salem HA (2018) Current clinical applications of platelet-rich plasma in various gynecological disorders: an appraisal of theory and practice. Clin Exp Reprod Med 45(2):67–74

    Article  Google Scholar 

  3. Andia E, Rubio-Azpeitia J, Martin I, Abate M (2015) Current concepts and translational uses of platelet rich plasma biotechnology; in Ekin- ci D (ed.): Biotechnology. InTech, DOI: https://doi.org/10.5772/59954. https://www.intechopen.com/books/biotechnology/current-concepts-and-translational-uses-of-plateletrich-plasma-biotechnology

  4. Sundman EA, Cole BJ, Fortier LA (2011) Growth factor and catabolic cytokine concentrations are influenced by the cellular composition of platelet-rich plasma. Am J Sports Med 39(10):2135–2140

    Article  Google Scholar 

  5. Gorlero F, Glorio M, Lorenzi P, Bruno-Franco M, Mazzei C (2012) New approach in vaginal prolapse repair: mini-invasive surgery associated with application of platelet-rich fibrin. Int Urogynecol J 23:715–722

    Article  Google Scholar 

  6. Shirvan MK, Alamdari DH, Ghoreifi A (2013) A novel method for iatrogenic vesicovaginal fistula treatment: autologous platelet rich plasma injection and platelet rich fibrin glue interposition. J Urol 189:2125–2129

    Article  Google Scholar 

  7. Mongardini M, Iachetta RP, Cola A, Maturo A, Giofre M, Custureri F (2009) Low rectovaginal fistula treated with platelet-rich plasma (PRP). G Chir 30:507–509

    CAS  PubMed  Google Scholar 

  8. Gottgens KW, Smeets RR, Stassen LP, Beets GL, Pierik M, Breukink SO (2015) Treatment of Crohn’s disease-related high perianal fistulas combining the mucosa advancement flap with platelet-rich plasma: a pilot study. Tech Coloproctol 19:455–459

    Article  CAS  Google Scholar 

  9. Castellani D, Valloni A, Piccirilli A, Paradiso Galatioto G, Vicentini C (2017) An innovative approach to treating vaginal mesh exposure after abdominal sacral colpopexy: endoscopic resection of mesh and platelet-rich plasma; initial experience in three women. Int Urogynecol J 28(2):325–327

    Article  Google Scholar 

  10. Medel S, Alarab M, Kufaishi H, Drutz H, Shynlova O (2015) Attachment of primary vaginal fibroblasts to absorbable and nonabsorbable implant materials coated with platelet-rich plasma: potential application in pelvic organ prolapse surgery. Female Pelvic Med Reconstr Surg 21:190–197

    Article  Google Scholar 

  11. Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JOL, Klarskov P, Shull BL, Smith ARB (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  CAS  Google Scholar 

  12. Yalcin I, Bump RC (2003) Validation of two global impression questionnaires for incontinence. Am J Obstet Gynecol 189(1):98–101

    Article  Google Scholar 

  13. Taylor DW, Petrera M, Hendry M, Theodoropoulos JS (2011) A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clin J Sport Med 21(4):344–352

    Article  Google Scholar 

  14. 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  Google Scholar 

  15. Fekete Z, Körösi S, Németh G (2018) Hüvelyi hálóműtétek gyakorlata az amerikai korlátozó figyelmeztetés után. Merjem, vagy ne merjem? [Vaginal mesh operations in the urogynecological practice after the FDA warnings. Use or not to use mesh?]. Orv Hetil 159(10):397–404

    Article  Google Scholar 

  16. Mucowski SJ, Jurnalov C, Phelps JY (2010) Use of vaginal mesh in the face of recent FDA warnings and litigation. Am J Obstet Gynecol 203(2):103.e1–103.e1034

    Article  Google Scholar 

  17. Jackson SR, Avery NC, Tarlton JF, Eckford SD, Abrams P, Bailey AJ (1996) Changes in metabolism of collagen in genitourinary prolapse. Lancet. 347(9016):1658–1661

    Article  CAS  Google Scholar 

  18. Chrysanthopoulou EL, Pergialiotis V, Perrea D, Κourkoulis S, Verikokos C, Doumouchtsis SK (2017) Platelet rich plasma as a minimally invasive approach to uterine prolapse. Med Hypotheses 104:97–100

    Article  CAS  Google Scholar 

  19. Nikolopoulos KI, Pergialiotis V, Perrea D, Doumouchtsis SK (2016) Restoration of the pubourethral ligament with platelet rich plasma for the treatment of stress urinary incontinence. Med Hypotheses 90:29–31

    Article  Google Scholar 

  20. Kaux JF, Drion P, Croisier JL, et al. (2014) Plasma riche en plaquettes et lésions tendineuses [Chronic tendinopathies and platelet-rich plasma]. Rev Med Liege. 69 Spec No:72–77

  21. Maher C, Feiner B, Baessler K, Christmann-Schmid C, Haya N, Brown J (2016) Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev 11(11):CD004014

    PubMed  Google Scholar 

  22. Vergeldt TF, Notten KJ, Weemhoff M, van Kuijk S, Mulder FEM, Beets-Tan RG, Vliegen RFA, Gondrie ETCM, Bergmans MGM, Roovers JPWR, Kluivers KB (2015) Levator hiatal area as a risk factor for cystocele recurrence after surgery: a prospective study. BJOG. 122(8):1130–1137

    Article  CAS  Google Scholar 

  23. Tijdink MM, Vierhout ME, Heesakkers JP, Withagen MI (2011) Surgical management of mesh-related complications after prior pelvic floor reconstructive surgery with mesh. Int Urogynecol J 22(11):1395–1404

    Article  Google Scholar 

  24. Vizcaíno G (2016) Tratamiento ortobiológico con plasma rico en plaquetas? Hay suficiente evidencia para su recomendación? [Orthobiologic treatment with platelet-rich plasma: is there sufficient evidence for its recommendation?]. Investig Clin 57(1):1–2

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Urogynecology, Medipol Mega Üniversity Hospital, Bağcılar, İstanbul, Turkey

    Adeviye Elçi Atılgan

  2. Faculty of Medicine, Department of Urology, Necmettin Erbakan Üniversity Meram, Konya, Turkey

    Arif Aydın

Authors
  1. Adeviye Elçi Atılgan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arif Aydın
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Adeviye Elçi Atılgan contributed to the study design and writing. Arif Aydın contributed to the statistical analaysis.

Corresponding author

Correspondence to Adeviye Elçi Atılgan.

Ethics declarations

Conflict of İnterest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic Supplementary Material

ESM 1

(DOCX 37 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Atılgan, A.E., Aydın, A. Cystocele Repair with Platelet-Rich Plasma. Indian J Surg 83, 726–730 (2021). https://doi.org/10.1007/s12262-020-02459-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-020-02459-6

Keywords

Search

Navigation