Abstract
Introduction and hypothesis
To determine the reoperation rate for symptomatic recurrence of cystoceles following traditional anterior colporrhaphy (without mesh).
Methods
Retrospective case note review of 207 cases of primary anterior colporrhaphy with/without other prolapse surgery. All patients received a 3-month clinic follow-up. Reoperation details for prolapse and/or urinary incontinence were obtained from patients general practitioners with a median follow-up of 50 months.
Results
The median age was 60 years (32–85), and median parity was 2. Twenty-nine of 207 (14%) patients had previous gynecological surgery. While the anatomical recurrence rate of cystoceles at 3 months postoperatively was 12%, the reoperation rate for recurrent cystocele by 50 months was 3.4%. Overall, 9.1% of the group underwent prolapse or incontinence surgery during this period.
Conclusions
While the anatomical recurrence rates for cystocele following traditional anterior colporrhaphy might be high, the low reoperation rate at more than 4 years (3.4%) suggests that patient's symptoms might not be bothersome enough to require further surgery. Both subjective and anatomical outcomes are required to assess the outcome of both traditional and new prolapse procedures.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bump RC, Norton PA (1998) Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin N Am 25:723–746
Swift SE, Tate SB, Nicholas J (2003) Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol 189:372–377
Olsen AL et al (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506
Boyles S, Weber A, Meyn L (2003) Procedures for pelvic organ prolapse in the United States 1979–1997. Am J Obstet Gynecol 188:108–115
Clark AL, Gregory T, Smith VJ, Edwards R (2003) Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 189:1261–1267
Denman MA, Gregory WT, Boyles SH, Smith V, Edwards R, Clark AL (2008) Reoperation rate 10 years after surgically managed pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 198:555.e1–555.e5
Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomised trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1304
Hiltunen R, Nieminen K, Takala T, Heiskanen E, Merikari M, Niemei K, Heinonen PK (2007) Low-weight polypropylene mesh for anterior vaginal wall prolapse: a randomized controlled trial. Obstet Gynecol 110:455–462
Handel LN, Frenkl TL, Kim YH (2007) Results of cystocele repair: a comparison of traditional anterior colporrhaphy, polypropylene mesh and porcine dermis. J Urol 178:153–156
Meschia M, Pifarotti P, Bernasconi F, Magatti F, Riva D, Kocjancic E (2007) Porcine skin collagen implants to prevent anterior vaginal wall prolapse recurrence: a multicenter, randomised study. J Urol 177:192–195
Brubaker L, Bump R, Fynes M et al (2004) Surgery for pelvic organ prolapse. In: Incontinence. Abrams P, Cardozo L, Khoury s, Wein A (Eds):2: 1397
Maher C, Baessler K (2006) Surgical management of anterior vaginal wall prolapse: an evidence-based literature review. Int Urogynecol J Pelvic Floor Dysfunct 17:195–201
Jia X, Glazener C, Mowatt G, MacLennan G, Fraser C, Burr J (2008) Systematic review of the efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse. BJOG 115:1350–1361
Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17
Barber MD (2005) Symptoms and outcome measures of pelvic organ prolapse. Clin Obstet Gynecol 48:648–661
Elkadry EA, Kenton KS, Fitzgerald MP, Shott S, Brubaker L (2003) Patient-selected goals: a new perspective on surgical outcome. Am J Obstet Gynecol 189:1551–1557
Whiteside JL, Weber AM, Meyn LA, Walters MD (2004) Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 191:1533–1538
Miedel A, Tegerstedt G, Morlin B, Hammarstrom M (2008) A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse. Int Urogynecol J 19:1593–1601
Hawkins E, Raajkumar S, Masood M (2008) Long-term satisfaction with prolapse surgery in general gynaecology. Int Urogynecol J Pelvic Floor Dysfunct 19:1441–1448
Bradley CS, Nygaard IE (2005) Vaginal wall descensus and pelvic floor symptoms in older women. Obstet Gynecol 106:759–766
Te Linde RW (1959) A philosophy of pelvic surgery. Obstet Gynecol 14:253–256
Rogers RG (2006) The vexing problem of hidden incontinence. N Engl J Med 354:1627–1629
Burgio KL, Nygaard IE, Richter HE, Brubaker L et al (2007) Bladder symptoms one year after abdominal sacrocolpopexy with and without Burch colposuspension in women without preoperative stress incontinence symptoms. Am J Obtet Gynecol 197:647.e1–647.e6
Sources of financial support
None.
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kapoor, D.S., Nemcova, M., Pantazis, K. et al. Reoperation rate for traditional anterior vaginal repair: analysis of 207 cases with a median 4-year follow-up. Int Urogynecol J 21, 27–31 (2010). https://doi.org/10.1007/s00192-009-0991-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-009-0991-x