title: Incidence of recurrent cystocele after anterior colporrhaphy with and without concomitant transvaginal needle suspension.
abstract: OBJECTIVE
  Our purpose was to compare the recurrent cystocele rate after anterior colporrhaphy versus anterior colporrhaphy performed in conjunction with transvaginal needle bladder neck suspension.
  
  
  METHODS
  A retrospective chart review of all patients undergoing anterior colporrhaphy with and without needle bladder neck suspension over a 3-year period was conducted. Preoperatively all patients had symptomatic anterior vaginal wall relaxation. Patients undergoing concomitant needle suspension procedures had genuine stress incontinence. Twenty-seven patients underwent anterior colporrhaphy alone, and 40 patients underwent anterior colporrhaphy with needle suspension. Demographic data including age, parity, menopausal status, and use of estrogen replacement was collected for each group. The recurrence rate of anterior vaginal wall relaxation was determined for each group by reviewing standardized postoperative office notes.
  
  
  RESULTS
  There was no significant difference in the duration of follow-up between the two groups (13.2 months in the anterior repair group vs 13 months in the anterior repair-needle suspension group). However, a significant difference in recurrent cystocele rates was found between the two groups (7% [2/ 27] in the anterior repair group compared with 33% [13/40] in the anterior repair-needle suspension group, p < 0.01).
  
  
  CONCLUSIONS
  The incidence of recurrent cystocele is significantly higher after anterior colporrhaphy with concomitant needle bladder neck suspension compared with anterior colporrhaphy alone. This difference may be related to the vaginal retropubic dissection at the time of transvaginal needle bladder neck suspension resulting in an iatrogenic paravaginal defect or denervation of the anterior vaginal wall.
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Good Samaritan Hospital, University of Cincinnati School of Medicine, OH 45220, USA.
authors.forename: N
authors.initials: N
authors.lastname: Kohli
authors.forename: E H
authors.initials: EH
authors.lastname: Sze
authors.forename: T W
authors.initials: TW
authors.lastname: Roat
authors.forename: M M
authors.initials: MM
authors.lastname: Karram
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009339:Needles; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013537:Sutures; D001745:Urinary Bladder Diseases / Q000453:epidemiology* / Q000601:surgery*; D014621:Vagina / Q000601:surgery*