Abstract
Introduction and hypothesis
A posterior vaginal wall prolapse is the result of specific tears in the rectovaginal fascia. The prevalence of the different defect types (superior, inferior, overstretching) is unknown, as is the subjective results after operation according to defect type. The aims of this retrospective study were to investigate the prevalence of the different injury sites and the subjective effects after an operation concerning the symptomatic feeling of a vaginal bulge and urinary incontinence in relation to defect types.
Methods
Medical case records and data from the national Danish urogynecological database in patients with a prolapse operation including posterior vaginal wall prolapse for a 6-year period were reviewed. Four hundred and five patients were included. Patients completed the International Consultation on Incontinence-Urinary Incontinence Short Form and three questions on vaginal prolapse symptoms before and 3 months postoperatively.
Results
The majority of women suffered from a superior defect (77 %). There was a statistically significant improvement in prolapse symptoms after surgery, with no difference between patients with different defect types. Patients with a superior defect and overstretching also experienced a statistically significant improvement in urinary incontinence.
Conclusions
The superior defect was the most common defect in the rectovaginal fascia. Patients experienced an improvement in subjective prolapse symptoms concerning the feeling of a vaginal bulge with no difference regarding defect type. Patients with a superior defect or overstretching experienced a statistically significant improvement in urinary incontinence. Similar results were found whether or not concomitant prolapse operations were performed in other compartments.
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References
Richardson AC (1993) The rectovaginal septum revisited: its relationship to rectocele and its importance in rectocele repair. Clin Obstet Gynecol 36:976–983
Richardson ML, Elliot CS, Sokol ER (2012) Posterior compartment prolapse: a urogynecology perspective. Urol Clin N Am 39:361–369
Lefevre R, Davila GW (2008) Functional disorders: rectocele. Clin Colon Rectal Surg 21:129–137
Beck DE, Allen NL (2010) Rectocele. Clin Colon Rectal Surg 23:90–98
Guldberg R, Brostrøm S, Hansen JK, Kærlev L, Gradel KO, Nørgård BM, Kesmodel US (2013) The Danish Urogynecological Database: establishment, completeness and validity. Int Urogynecol J 24:983–990
Avery K, Donnovan J, Peters TJ, Shaw C, Gotoh M, Abrams P (2004) A brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 23:322–330
Price N, Jackson SR, Avery K, Brookes ST, Abrams P (2006) Development and psychometric evaluation of the ICIQ Vaginal Symptoms Questionnaire: the ICIQ-VS. BJOG 113(6):700–712
Nguyen JK, Bhatia NN (2001) Resolution of motor urge incontinence after surgical repair of pelvic organ prolapse. J Urol 166:2263–2266
Digesu GA, Salvatore S, Chaliha C, Athanasiou S, Milani R, Khullar V (2007) Do overactive bladder symptoms improve after repair of anterior vaginal wall prolapse? Int Urogynecol J Pelvic Floor Dysfunct 18:1439–1443
Miranne JM, Lopes V, Carberry CL, Sung VW (2013) The effect of pelvic organ prolapse severity on improvement in overactive bladder symptoms after pelvic reconstructive surgery. Int Urogynecol J 24:1303–1308
Costantini E, Lazzeri M, Zucchi A, Mearini L, Fragala E, Del Zingaro M, Bini V, Porena M (2013) Urgency, detrusor overactivity and posterior vault prolapse in women who underwent pelvic organ prolapse repair. Urol Int 90:168–173
Glavind K, Larsen T, Lindquist ASI (2015) Sexual function in women before and after surgery for pelvic organ prolapse. Acta Obstet Gynecol Scand 94:80–85
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Glavind, K., Christiansen, A.G. Site-specific colporrhaphy in posterior compartment pelvic organ prolapse. Int Urogynecol J 27, 735–739 (2016). https://doi.org/10.1007/s00192-015-2870-y
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DOI: https://doi.org/10.1007/s00192-015-2870-y