title: Midline anterior repair alone vs anterior repair plus vaginal paravaginal repair: a comparison of anatomic and quality of life outcomes.
abstract: Our aim was to study the anatomic recurrence rates and quality of life outcomes of patients who had undergone either anterior colporrhaphy (AC) or anterior colporrhaphy and vaginal paravaginal repair (AC + VPVR) as part of surgery for pelvic organ prolapse. Chart reviews were used to identify anatomic prolapse recurrence. Phone interviews assessed quality of life outcomes [Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ)] outcomes. There was a trend towards longer time to anatomic recurrence (any compartment > or =grade 2) in the AC group compared with the AC + VPVR group (median 24 vs 13 months, p=0.069). If only patients who had undergone previous surgery were compared, time to anatomic recurrence appeared significantly longer in the AC group (median 41 vs 12 months, p=0.022). There were 55% of women in the AC group and 46% of women in the AC + VPVR group who reported significant bladder or bulge symptoms based on responses to the phone-administered UDI and IIQ (p=0.89). Our retrospective study did not suggest that adding VPVR was superior in terms of anatomic or quality of life outcomes. Prospective assessment of the role of VPVR in the treatment of pelvic organ prolapse is needed.
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA, USA. MorseA@ummhc.org
authors.forename: Abraham N
authors.initials: AN
authors.lastname: Morse
authors.forename: Katharine K
authors.initials: KK
authors.lastname: O'dell
authors.forename: Allison E
authors.initials: AE
authors.lastname: Howard
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Baker
authors.forename: Michael P
authors.initials: MP
authors.lastname: Aronson
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Young
mesh_terms: D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery*