Anterior Colporrhaphy: Outcomes Assessment in Relation to Pre-Operative Urinary Symptoms

Abstract

Background and Aim: Anterior colporrhaphy means plication of the anterior vaginal wall fibromuscular layer to correct the prolapse and to support the bladder, and is considered a traditional procedure. Urinary symptoms may associate cystocele like irritative urinary symptoms and stress incontinence and these symptoms may be relieved upon cystocele correction. However, cystocele repair may lead to urinary symptoms due to extensive local dissection of the anterior vaginal wall that results in bladder denervation injury. The aim of this study is to study the urinary symptoms before and after cystocele repair. Patients and Methods: A prospective cross-sectional study was performed including 100 patients referred for anterior colporrhaphy surgery from March 2018 through December 2019 at the departments of Urology and gynecology at Azadi Teaching Hospital and Duhok Maternity Hospital in Duhok City, Kurdistan Region/Iraq. Pre and postoperative urological symptoms were evaluated. Results: One hundred female patients subjected to anterior colporrhaphy, the mean patient's age was 39.42 years, the mean parity was 5.57 and BMI was 28.60. Seventy-five 75% of patients had history of vaginal delivery, while 25% of them had history of both vaginal delivery and cesarean section. The results show significant improvement of vaginal bulge by 92%, Stressincontinence(SI) 71.4%, urge incontinence 67%, frequency 59%, urgency 57.3%, nocturia 57% and dyspareunia 60%. Meanwhile, urinary tract infection and obstructive urinary symptoms were not significantly improved. Conclusion:The study showed that women with coexistent irritative urinary symptoms and stress urinary incontinence with POP will show significant improvement after surgery.