Anterior colporrhaphy: A randomized trial of three surgical techniques

Weber, Anne M.; Walters, Mark D.; Piedmonte, Marion; Ballard, Lester A.

doi:10.1067/mob.2001.119081

Cited by 508 publications

(326 citation statements)

References 18 publications

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“…In a study on 209 patients at a mean of 2.2 years after Perigee or Anterior Prolift, 35% of women with avulsion were shown to have recurrent cystocele on ultrasound as compared to 19% of those in whom the levator was intact (odds ratio 2.24) 56 . In a study on prolapse recurrence, 43 which included 334 patients at a mean follow‐up of 2.5 years after cystocele repair, levator avulsion was associated with an odds ratio of 2.95 for recurrence, and hiatal area on Valsalva conveyed an additional 7% per cm 2 for risk of recurrence (Figure 6 and 7). This implies that the likelihood of recurrence may vary from 10 to 90% in a patient with a given degree of cystocele, depending on the integrity of the levator ani muscle and hiatal area on Valsalva 44 (Figure 8).…”

Section: Methodsmentioning

confidence: 99%

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Imaging of slings and meshes

Shek

Dietz

2014

Australas J Ultrason Med

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The popularity of imaging in pelvic floor medicine continues to increase. Among the various modalities, ultrasound is superior as it is cheap, safe, easily accesible and simple, resulting in high patient compliance. It is the only technique that allows imaging of modern wide‐weave polypropylene sling or mesh implants, and imaging of such implants is commonly required due to the popularity of surgical techniques that involve the placement of slings and meshes. This review article will discuss the role of translabial ultrasound in the evaluation of synthetic implants used in the treatment of urinary incontinence and pelvic organ prolapse.

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Section: Methodsmentioning

confidence: 99%

“…The limit of normality (mean plus 2 standard deviation 57 or as a predictor of symptoms of prolapse 58 ) is 25 cm 2 . Reproduced with permission from reference 59.…”

Section: Methodsmentioning

confidence: 99%

Imaging of slings and meshes

Shek

Dietz

2014

Australas J Ultrason Med

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“…Therefore, restoration of the anatomical defects should be accompanied by improvement of the A wide variety of trans-abdominal and transvaginal procedures have been developed for the repair of an anterior wall prolapse. However, the failure or recurrence rate has been reported to be as high as 30% to 50%, regardless of the approach or the technique [4,5]. In a repair of an anterior vaginal wall prolapse, because the pubocervical fascia becomes detached or torn, it is necessary to restore the natural function of the fascia.…”

Section: Introductionmentioning

confidence: 99%

“…In a repair of an anterior vaginal wall prolapse, because the pubocervical fascia becomes detached or torn, it is necessary to restore the natural function of the fascia. However, reinforcement of the pubocervical fascia by plication of the damaged fascia or through the placement of an absorbable mesh results in an unacceptably high recurrence rate [4][5][6]. Accordingly, a nonabsorbable mesh has been used to reinforce or replace the natural structures.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of "Tension-free" Placement of Gynemesh PS for the Treatment of Anterior Vaginal Wall Prolapse

et al. 2010

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Purpose: To evaluate the efficacy and safety of the tension-free placement of a monofilament polypropylene mesh for the repair of an anterior vaginal wall prolapse (AVWP). Materials and Methods: Women aged ≥ 30 years with an AVWP stage of II or greater were included. Forty-nine women underwent trans-vaginal repair using a Gynemesh TM PS. Forty-six women who had symptomatic stress urinary incontinence received a midurethral sling (MUS). At the 12-month follow-up, evaluations were made for changes in the Pelvic Organ Prolapse Quantification (POP-Q) stage and Pelvic Floor Distress Inventory. Cure was defined as a POP-Q stage of 0 and improvement as a stage of I. Complications were also evaluated. Results: The cure rate was 71.4%, and the improvement rate was 18.4%. Obstructive/discomfort, irritative, and stress subscale scores of the Urinary Distress Inventory anterior and posterior subscale scores of the POP Distress Inventory and the obstructive subscale score of the Colo-Rectal-Anal Distress Inventory were significantly improved. Thirty-two of the 46 women (69.6%) who received MUS procedures reported no leakage after surgery. Complications were 2 cases of increased intraoperative bleeding and 1 case of vaginal erosion. Conclusions: Trans-vaginal repair using a Gynemesh TM PS is a feasible and effective procedure for the treatment of AVWP with no significant complications.

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“…The most common type of POP is anterior vaginal wall prolapse (AVWP) with a reported incidence of 34.3% (2). Although still commonly used by many pelvic reconstructive surgeons, traditional colporrhaphy for AVWP repair has a recurrence rate of up to 20% (3) with a more recently reported failure rate up to 70% (4). During traditional colporrhaphy, the laterally placed pubocervical fascia is medially plicated; however, this technique is thought to potentially lead to vaginal shortening and narrowing (5).…”

Section: Introductionmentioning

confidence: 99%

The outcome of transobturator anterior vaginal wall prolapse repair using porcine dermis graft: intermediate term follow-up

Mahdy¹,

Karp

Davila

et al. 2013

Int. braz j urol.

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Introduction and Hypothesis:We evaluated the anatomical success and complications of Perigee® with porcine dermis Graft in the repair of anterior vaginal wall prolapse (AVWP) Materials and Methods: After Institutional Review Board (IRB) approval, the charts of all patients who underwent AVWP repair using the Perigee/InteXen® kit from July 2005 to July 2009 were reviewed. Patients who had less than 6-month follow-up were excluded. Preoperative data including patient age, previous AVWP repairs, hysterectomy status, preoperative dyspareunia and pertinent physical findings were collected and recorded. Postoperative success was defined as anatomical stage 0 or I using the Pelvic Organ Prolapse Quantification (POP-Q) scoring system. Graft related complications were also recorded. Results: Out of 89 patients, 69 completed at least 6-month follow-up. Median follow-up was 13 (6-48) months. Seventeen patients (25%) had previous AVWP repair and 32 (46%) had previous hysterectomy. Preoperatively, AVWP stage II was found in 9 (13%), stage III in 27 (39%) and stage IV in 33 (48%) patients. Anatomic success was found in 48 (69%) patients, with 23 (33%) having stage 0 and 25 (36%) stage I AVWP. Intraoperative complications included incidental cystotomy in one patient and bladder perforation in one. Postoperative complications included vaginal exposure and dyspareunia in one case, wound dehiscence in one and tenderness over the graft arm with dyspareunia in one. Conclusions: The use of porcine dermis in AVWP repair is safe with minimal graft related complications; however, anatomical success is lower than that reported with the use of synthetic grafts.

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Anterior colporrhaphy: A randomized trial of three surgical techniques

Cited by 508 publications

References 18 publications

Imaging of slings and meshes

Imaging of slings and meshes

Efficacy and Safety of "Tension-free" Placement of Gynemesh PS for the Treatment of Anterior Vaginal Wall Prolapse

The outcome of transobturator anterior vaginal wall prolapse repair using porcine dermis graft: intermediate term follow-up

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