Short- and long-term outcomes of patients with anterior vaginal wall prolapse after abdominal paravaginal cystocele repair

Abstract

Objective

Pelvic organ prolapse (POP) is a common condition for women, causing urinary dysfunction, discomfort due to the lump at the introitus, sexual dysfunction and difficulty with bowel emptying. The lifetime risk for surgical intervention is 12.6 % by age 80, with 19 % of women requiring a secondary operation due to recurrence. Abdominal paravaginal cystocele repair is an option of treatment for women with Baden–Walker Grade 4 or recurrent cystocele in our centre. Therefore, the short- and long-term outcomes were investigated to evaluate the efficacy of treatment.

Materials and methods

Thirty-one women were followed up for 3 years post-surgery, to assess the subjective cure rate (patients not complaining of a lump at the introitus) and objective cure rate (cystocele less than and equal to Baden–Walker Grade 1).

Results

The subjective cure rate was 70 % at one-year post-operation, and thereafter maintained at 65 % two- and three-years post-operation. The objective cure rate was 90.3 % in the first month post-operation, 63.0 % at six-months post-operation, and maintained at 40 % from the first year onwards. A second surgery was required in 6 patients (19.4 %). Overall patient satisfaction was excellent, with more than 95 % of patients being satisfied with the operation up to 3 years post-surgery.

Conclusions

Overall, the objective and subjective cure rates were comparable with that of other centres, although the rate of recurrence is still high. This information will be beneficial for clinicians and patients to make an informed decision when considering the various surgical treatment options for managing advanced anterior vaginal wall prolapse.