Anatomic and Functional Outcome of Vaginal Paravaginal Repair in the Correction of Anterior Vaginal Wall Prolapse

Abstract

Over a 2-year period 45 patients with bilateral paravaginal support defects underwent vaginal paravaginal repair. Postoperative evaluations were conducted and anatomic outcome was determined by vaginal examination, with grading of vaginal wall support. Functional outcome was assessed by a standardized quality of life questionnaire, voiding dairy and standing stress test with a full bladder. Thirty-five patients had long-term follow-up with a mean of 1.6 years (range 1-85). The recurrence rates for displacement cystocele, enterocele and rectocele were 3% (1/35), 20% (7/35) and 14% (5/35), respectively. In no patients did vault prolapse develop or recur. Subjective or objective evidence of persistent stress urinary incontinence was found in 57% of patients (12/21). Vaginal paravaginal repair is a safe and effective technique for the surgical correction of anterior vaginal wall prolapse but has limited applicability in the surgical correction of genuine stress incontinence.

Anterior compartment prolapse repair with a hybrid biosynthetic mesh implant technique

“…Dyspareunia is one of the disadvantages of the anterior vaginal wall prolapse repair using nonabsorbable synthetic meshes [11,13,18,35]. Milani et al [13] found a 20% increase of dyspareunia after anterior repair reinforced by polypropylene mesh.…”

Surgical management of anterior vaginal wall prolapse: an evidencebased literature review

“…Although the success rates of the vaginal paravaginal repair for cystoceles in case series vary from 67-100% [19][20][21][22][23][24], significant complications have been reported recently. Mallipeddi et al [21] reported on complications in a series of 45 women including 1 bilateral ureteric obstruction, 1 retropubic haematoma requiring surgery, [25]. There are no randomized controlled or case-control trials on the surgical repair of paravaginal defects.…”

Graft Augmentation in Surgical Repair of Anterior Vaginal Wall Prolapse

“…19,20 Similarly, studies involving vaginal paravaginal repair have reported success rates ranging from 92% to 98%, although mean follow-up time has been limited to 1 year or less. [21][22][23] Additionally, compared with the abdominal approach, vaginal paravaginal repair is technically more challenging and may be associated with an increased risk of operative complications, including lower urinary tract injury and bleeding. 21…”