TY - JOUR
T1 - Clinical and urodynamic effects of anterior colporraphy and approximation of pubococcygeus muscles in patients with severe cystocele
AU - Paparella, Pierluigi
AU - Ercoli, Alfredo
AU - Groutz, Asna
AU - Falconi, Gabriele
AU - Marturano, Monia
AU - Paparella, Raffaele
AU - Contreras Ortiz, Oscar
PY - 2005/3
Y1 - 2005/3
N2 - Objective: The objective was to evaluate in a homogeneous series of patients the clinical and urodynamic outcomes following anterior colporraphy and approximation of pubococcygeus muscles for correcting cystocele and genuine stress incontinence (SUI). Methods: The authors analyzed the pre- and postoperative clinical and urodynamic data of 56 consecutive, not previously operated, patients underwent anterior colporraphy and approximation of pubococcygeus muscles by the same surgeon. The mean follow-up period was 20 months (range 12-32). Statistical analysis was performed with Wilcoxon matched pairs test and Fisher's exact test. Results: Four (8%) patients experienced cystocele recurrence at a lesser degree than preoperatively and 2 (4%) patients developed grade II rectocele postoperatively. Recurrence of cystocele occurred only among those patients undergone sacrospinous colposuspension (4 out of 20 vs. 0 out of 32, P=0.018). Manifested and potential genuine stress incontinence (Pot-SUI) treatment was successful in 18 out of 30 (60%) patients. These patients showed a significant increase (P<0.001) of bladder-to-urethra pressure transmission ratio (PTR) values whereas, in those patients who presented recurrence, such an increase did not occur. Conclusion: Anterior colporraphy and approximation of pubococcygeus muscles appears, from our preliminary results to be a safe, effective technique for the primary treatment of cystocele without compromising the other vaginal profiles but should not be considered as the procedure of choice for patients presenting with manifested or Pot-SUI. Long-term follow-up is needed to evaluate whether these results are durable.
AB - Objective: The objective was to evaluate in a homogeneous series of patients the clinical and urodynamic outcomes following anterior colporraphy and approximation of pubococcygeus muscles for correcting cystocele and genuine stress incontinence (SUI). Methods: The authors analyzed the pre- and postoperative clinical and urodynamic data of 56 consecutive, not previously operated, patients underwent anterior colporraphy and approximation of pubococcygeus muscles by the same surgeon. The mean follow-up period was 20 months (range 12-32). Statistical analysis was performed with Wilcoxon matched pairs test and Fisher's exact test. Results: Four (8%) patients experienced cystocele recurrence at a lesser degree than preoperatively and 2 (4%) patients developed grade II rectocele postoperatively. Recurrence of cystocele occurred only among those patients undergone sacrospinous colposuspension (4 out of 20 vs. 0 out of 32, P=0.018). Manifested and potential genuine stress incontinence (Pot-SUI) treatment was successful in 18 out of 30 (60%) patients. These patients showed a significant increase (P<0.001) of bladder-to-urethra pressure transmission ratio (PTR) values whereas, in those patients who presented recurrence, such an increase did not occur. Conclusion: Anterior colporraphy and approximation of pubococcygeus muscles appears, from our preliminary results to be a safe, effective technique for the primary treatment of cystocele without compromising the other vaginal profiles but should not be considered as the procedure of choice for patients presenting with manifested or Pot-SUI. Long-term follow-up is needed to evaluate whether these results are durable.
KW - Anterior colporraphy
KW - Cystocele
KW - Pubococcygeus muscles
KW - Stress incontinence
UR - http://www.scopus.com/inward/record.url?scp=17644426002&partnerID=8YFLogxK
U2 - 10.1007/s00404-004-0637-7
DO - 10.1007/s00404-004-0637-7
M3 - Article
SN - 0932-0067
VL - 271
SP - 195
EP - 199
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 3
ER -