Outcomes of Surgery with Vaginal Native Tissue for Posterior Vaginal Wall Prolapse Using a Special Technique

J Med Life. 2020 Oct-Dec;13(4):554-561. doi: 10.25122/jml-2020-0093.

Abstract

There are several techniques for repairing prolapse in the posterior vaginal compartment, yet there is no general agreement on the best surgical procedure. This study was performed to investigate the outcomes of the common vaginal route technique for posterior vaginal wall prolapse repair in the first Iranian fellowship teaching center for female pelvic floor disorders. This prospective cohort study was performed on women with posterior vaginal wall prolapse with or without prolapse of other vaginal compartments who underwent surgery between 2014 and 2018 in a referral center for female pelvic floor disorders. A follow-up period of 12 months was considered. Patients subjected to the transvaginal technique by attachment of the rectovaginal fascia to the pericervical ring using vaginal native tissue were included. Among the 107 patients, the Pelvic Floor Distress Inventory-20 (PFDI-20) scores were 141.87 ± 34.48 and 100.87 ± 26.48 before and after surgery, respectively, showing the significant improvement of patient's symptoms after surgery in the 12-month follow-up. Comparing Pelvic Organ Prolapse Quantification (POP-Q) results before and after surgery, a significant improvement in patients' conditions was seen at the 12-month follow-up. Based on the results of the present study, the surgical procedure of the rectovaginal fascia attachment to the pericervical ring in posterior vaginal wall prolapse repair seems an effective surgical intervention without significant morbidity in the short-term follow-up.

Keywords: Pelvic organ prolapse; enterocele; prolapse surgery; rectocele.

MeSH terms

  • Aged
  • Female
  • Humans
  • Iran
  • Middle Aged
  • Pelvic Organ Prolapse / surgery*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Surgical Mesh
  • Surveys and Questionnaires
  • Treatment Outcome
  • Uterine Prolapse / surgery*
  • Vagina / surgery*
  • Young Adult