H P Dietz1, V Chantarasorn, K L Shek. 1. Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Penrith, Australia. hpdietz@bigpond.com
Abstract
OBJECTIVES: To determine whether levator avulsion is a risk factor for recurrence after cystocele repair. METHODS: This was an audit of women who underwent anterior colporrhaphy at a tertiary hospital between 2002 and 2005, who were followed up by interview, clinical examination and four-dimensional translabial ultrasound examination 3-6 years later. RESULTS: Of 242 patients identified through theater records we were able to contact 171 (71%). Of 83 who agreed to attend, 24 (29%) reported symptoms of recurrent prolapse. There were 33 (40%) recurrent cystoceles (ICS POP-Q ≥ 0), [corrected] and 34 (41%) had a significant cystocele on ultrasound examination. On pelvic floor tomographic ultrasound examination, a levator avulsion was detected in 29 (35%) patients. The relative risk of recurrence in women with avulsion was 3.9 (95% CI, 2.4-5.8) when ultrasound criteria of recurrent cystocele were used, and 2.9 (95% CI, 1.7-4.5) when using clinical staging. CONCLUSION: Levator avulsion is associated with a relative risk of 3-4 for cystocele recurrence after anterior colporrhaphy. Copyright 2010 ISUOG. Published by John Wiley & Sons, Ltd.
OBJECTIVES: To determine whether levator avulsion is a risk factor for recurrence after cystocele repair. METHODS: This was an audit of women who underwent anterior colporrhaphy at a tertiary hospital between 2002 and 2005, who were followed up by interview, clinical examination and four-dimensional translabial ultrasound examination 3-6 years later. RESULTS: Of 242 patients identified through theater records we were able to contact 171 (71%). Of 83 who agreed to attend, 24 (29%) reported symptoms of recurrent prolapse. There were 33 (40%) recurrent cystoceles (ICS POP-Q ≥ 0), [corrected] and 34 (41%) had a significant cystocele on ultrasound examination. On pelvic floor tomographic ultrasound examination, a levator avulsion was detected in 29 (35%) patients. The relative risk of recurrence in women with avulsion was 3.9 (95% CI, 2.4-5.8) when ultrasound criteria of recurrent cystocele were used, and 2.9 (95% CI, 1.7-4.5) when using clinical staging. CONCLUSION:Levator avulsion is associated with a relative risk of 3-4 for cystocele recurrence after anterior colporrhaphy. Copyright 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Authors: Stéphanie Thibault-Gagnon; Sara Yusuf; Suzanne Langer; Vivien Wong; Ka Lai Shek; Andrew Martin; Hans Peter Dietz Journal: Int Urogynecol J Date: 2014-05-23 Impact factor: 2.894
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