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Abstract

Objective:

To determine the long-term outcomes of anterior colporrhaphy with pubovaginal sling reinforcement in the management of high-grade cystocoele and significant urethral dysfunction.

Materials and Methods:

This is a retrospective case series. From May 2008 to October 2017, all patients who underwent concurrent anterior colporrhaphy and pubovaginal fascial sling performed by a single surgeon were included. Subjective success rates were determined from patient-reported outcomes on follow-up questionnaires using The Patient Global Impression of Improvement (PGI-I) scores. Primary outcome of this study was subjective cystocoele recurrence-free survival. Secondary outcome was complication rate.

Results:

Eighty patients were included with a median age of 63 years. All women had urethral dysfunction (type II urethral hypermobility or intrinsic sphincter deficiency) on fluoroscopic urodynamics in association with a high-grade cystocoele. The median follow-up time for recurrence of cystocoele was 36 months. The 1- and 5-year estimated cystocoele recurrence-free survival was 97.2% and 84.8%, respectively.

Conclusion:

Anterior colporrhaphy with concurrent pubovaginal sling reinforcement for treatment of high-grade cystocoele is a safe procedure with a high rate of success durable up to 5 years. The risk of complications is low with no patient developing chronic pain or rejection of the fascial graft.

Level of evidence:

Not applicable.

Keywords

Cystocoele prolapse colporrhaphy autologous fascial sling urinary incontinence

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Long-term surgical outcome of anterior colporrhaphy and autologous fascial sling (AFS) reinforcement for treatment of high-grade cystocoele