Transvaginal Cystocele Repair by Purse-String Technique Reinforced with Three Simple Sutures: Surgical Technique and Results

Abstract

PurposeDifferent techniques for cystocele repair including the conventional anterior colporrhaphy and mesh technique are known. Our goal was to evaluate the anatomical success and safety of our method of transvaginal anterior vaginal wall repair by the purse-string technique reinforced with three simple additional sutures in the repair of cystocele over a 4-year follow-up period.MethodsThis was a retrospective review of 69 consecutive patients (grades 2 to 4) who underwent the above operations between 2001 and 2011, including their success rates as assessed by use of the Baden-Walker halfway classification system.ResultsOf the patients, 62 patients (98%) were completely cured of cystocele and 1 patient showed grade 2 cystocele recurrence that required no further treatment. Two patients with grade 4 cystocele were completely cured. There was no vaginal erosion related to the cystocele repair.ConclusionsTransvaginal anterior colporrhaphy by a purse-string technique reinforced with simple additive sutures appears to be a simple, safe, and easily performed approach in cystocele repair. There is no need for other material for reinforcement, even in high-grade cystocele, which is an advantage of our technique.

Short term outcomes of a new non-dissection minimally invasive surgery method for cystocele repair

“…Cystocele occurs as a result of a defect in the pubocervical fascia [6]. It is possible to correct this defect with purse-string and reinforced sutures resulting in no recurrences and no postoperative voiding complications [6].…”

“…Cystocele occurs as a result of a defect in the pubocervical fascia [6]. It is possible to correct this defect with purse-string and reinforced sutures resulting in no recurrences and no postoperative voiding complications [6]. Given that many failures of anterior vaginal repairs are due to the weakness of vaginal apical supports [9], the success rates for cystocele repair may be improved by performing a concomitant apical procedure, such as the uterosacral or sacrospinous ligament suspension [4,10,11].…”

“…The goal of cystocele repair is to reinforce the cervicovaginal fascia [6]. Cystocele is most commonly treated by transvaginal repair using native tissue, i.e.…”

“…Anterior colporraphy has a reported success rate of only 30%, however this may be improved by using the correct suture type and placement [4]. Because of the high failure rate of these conventional methods, the use of a graft or mesh as reinforcing material has been popularized, but with specific complications [6]. Abdominal and laparoscopic sacral colpohysteropexy have also become an option for primary cystocele repair [7].…”

Anterior Colporrhaphy Technique and Approach Choices: Turkey Evaluation

“…(21) gevşemiş dokuları orta hatta birleştiren bohça dikişi (purse) ile bir araya getirerek fasya onarımı yaptığını bildirmişlerdir. Çalışmamızda katılımcıların %32,9'u klasik metodu kullanırken, %36,6'sı bohça süturü ve %30,5'i de hasar spesifik onarımı tercih ediyordu (20)(21)(22).…”