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VOLUME 5 , ISSUE 2 ( July-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

To Compare the Effectiveness of Traditional Anterior Colporrhaphy, Posterior Colpoperineorrhaphy with Site-specific Anterior and Posterior Repair for Pelvic Organ Prolapse

Krutika Bhalerao, Amishi Vora

Citation Information : Bhalerao K, Vora A. To Compare the Effectiveness of Traditional Anterior Colporrhaphy, Posterior Colpoperineorrhaphy with Site-specific Anterior and Posterior Repair for Pelvic Organ Prolapse. J South Asian Feder Menopause Soc 2017; 5 (2):92-98.

DOI: 10.5005/jp-journals-10032-1114

License: CC BY 3.0

Published Online: 01-07-2011

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Background

Pelvic organ prolapse (POP) is a common health problem affecting 40% multiparous women above 35 years of age. Lifetime risk of women requiring surgery for recurrence is 10%. The POP is intricious due to complex pelvic anatomy, and difficulty increases due to tissue weakness, lack of evidence-based surgical guidelines, and lack of standardized definition for surgical success, which results in highly variable estimates of success.

Aim

To compare the effectiveness of traditional anteroposterior repair with site-specific repair with concomitant vaginal hysterectomy with respect to anatomical considerations by POP-Q and functional or symptomatic considerations, complications, duration of surgery, and recurrence.

Materials and methods

This hospital-based randomized controlled trial was carried out at a tertiary care hospital from January 1, 2013 to December 31, 2015 over a period of 3 years after obtaining ethical committee approval. All women attending the gynecological outpatient department having symptoms of mass coming out of vagina were subjected to detailed history and examination and 51 women underwent traditional anterior and posterior repair and 44 women underwent site-specific repair with concomitant hysterectomy, with random sampling according to computerized sheet. The effectiveness of both the surgeries was assessed and compared.

Observations

There was statistically significant improvement in all the sites of POP-Q points using traditional repair and site-specific repair. When compared, site-specific repair by POP-Q was better than traditional method.

Conclusion

Site-specific repair of decussated natural tissue has great curative potential, and success is attributable to site-specific repair, rather than nonspecific scar formation by traditional method. Thus, it is important to properly quantify the repair to be done, whether anterior or posterior, and perform site-specific repair.

How to cite this article

Bhalerao AV, Vora A, Bhalerao K, Garg R. To Compare the Effectiveness of Traditional Anterior Colporrhaphy, Posterior Colpoperineorrhaphy with Site-specific Anterior and Posterior Repair for Pelvic Organ Prolapse. J South Asian Feder Menopause Soc 2017;5(2):92-98.


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  1. The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct 2001;12(3):178-186.
  2. Incontinence of urine in women. Url Cutaneous 1913;17:291-293.
  3. Am J Obstet Gynecol 2001 Dec;185(6):1299-1304.
  4. Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol 2001 Jun;184(7):1357-1356.
  5. A new look at pelvic relaxation. Am J Obstet Gynecol 1976 Nov 1;126(5):568-573.
  6. An anatomic operation for the cure of cystocele. Am J Obstet Dis Women Children 1912;65:286-290.
  7. Surgical management of prolapse of the anterior vaginal segment: an analysis of support defects, operative morbidity, and anatomical outcome. Am J Obstet Gynecol 1994;171(6):1429-1439.
  8. Anatomic and functional outcome of vaginal paravaginal repair in the correction of anterior vaginal wall prolapse. Int Uorgynecol J Pelvic Floor Dysfunct 2001;12(2):83-88.
  9. Clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy for prolapse with and without incontinence. Br J Obstet Gynaecol 1982 Jun;89(6):459-463.
  10. Transabdominal repair of cystocele, a 20 year experience, compared with the traditional vaginal approach. Am J Obstet Gynecol 1978 May 15;131(2):203-207.
  11. Urodynamic evaluation after vaginal repair and colposuspension. Br J Urol 1982 Aug;54(4):377-380.
  12. Long-term analysis of the surgical management of pelvic support defects. Am J Obstet Gynecol 1994 Dec;171(6):1518-1528.
  13. Randomised comparison of Burch colposuspension versus anteriorcolporrhaphy in women with stress urinary incontinence and anterior vaginal wall prolapse. BJOG 2000 Apr;107(4):544-551.
  14. Paraurethral fascial sling urethropexy and vaginal paravaginal defects cystopexy in the correction of urethrovesical prolapse. Int Urogynecol J Pelvic Flor Dystunct 1995 Mar;6(2):80-85.
  15. Transvaginal paravaginal repair: a useful adjunctive procedure at pelvic relaxation surgery. J Pelvic Surg 2000 Jan;6:11-15.
  16. Vaginal paravaginal repair: one-year outcomes. Am J Obstet Gynecol 2001 Dec;185(6):1360-1366; discussion 1366-1367.
  17. Midline anterior repair alone vs anterior repair plus vaginal paravaginal repair: a comparison of anatomic and quality of life outcomes. Int Urogynecol J Pelvic Floor Dysfunct 2007 Mar;18(3):245-249.
  18. Posterior colporrhaphy: its effects on bowel and sexual function. Br J Obstet Gynaecol 1997 Jan;104(1):82-86.
  19. Durability of success after rectocele repair. Int Urogynecol J Pelvic Floor Dystunct 2001;12(2):97-103.
  20. Rectocele repair. Four years' experience. Dis Colon Rectum 1990 Aug;33(8):684-687.
  21. Results of rectocele repair. A prospective study. Dis Colon Rectum 1995 Jan;38(1):7-13.
  22. Midline rectovaginal fascial plication for repair of rectocele and obstructed defecation. Obstet Gynecol 2004 Oct;104(4):685-689.
  23. Evaluation of the fascial technique for surgical repair of isolated posterior vaginal wall prolapse. Obstet Gynecol 2003 Feb;101(2):320-324.
  24. Fascial posterior colpoperineorrhaphy: a five year follow-up study. J Pelvic Med Surg 2003;9(6):279-283.
  25. Site-specific rectocele pair compared with standard posterior colporrhaphy. Obstet Gynecol 2005 Feb;105(2):314-318.
  26. An anatomic and function alasessment of the discrete defect rectocele repair. Am J Obstet Dis Women Children 1998 Dec;179(6 Pt 1):1451-1456; discussion 1456-1457.
  27. Outcome after rectovaginal fascia reattachment for rectocele repair. Am J Obstet Gynecol 1999 Dec;181(6):1360-1363.
  28. The anatomic and functional outcomes of defect-specific rectocele repairs. Am J Obstet Gynecol 1999 Dec;181(6):1353-1358.
  29. Rectocele repair: a randomized trial of three surgical techniques including graft augmentation. Am J Obstet Gynecol 2006 Dec;195(6):1762-1771.
  30. Place of mesh in vaginal surgery, including its removal and revision. Best Pract Res Clin Obstet Gynaecol 2011 Apr;25(2):197-203.
  31. org.uk/patient-information.php.
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