title: The natural history of posterior vaginal wall support after abdominal sacrocolpopexy with and without posterior colporrhaphy.
abstract: OBJECTIVE
  The objective of the study was to determine the degree of posterior vaginal wall support after abdominal sacrocolpopexy (ASC) with and without a posterior colporrhaphy as a function of time.
  
  
  METHODS
  Retrospective review was performed on women who underwent ASC between 1997 and 2004. Pelvic organ prolapse quantification (POP-Q) points Ap and Bp and stage of posterior compartment were collected at initial visit and at 1, 4, 10, 22, and 34 months after ASC.
  
  
  RESULTS
  Significant improvement of POP-Q point Ap and Bp and stage of posterior compartment was initially seen after ASC with or without posterior colporrhaphy. With concomitant posterior colporrhaphy, the improvement in Ap persisted 34 months after surgery. Mean Bp and stage of the posterior compartment returned to preoperative values after 10 months, regardless of whether a concurrent posterior colporrhaphy had been performed. Fifty-one of 191 women (29%) had subsequent stage 2 posterior wall prolapse, 4 (2%) of whom underwent subsequent posterior colporrhaphy.
  
  
  CONCLUSIONS
  For ASC with concomitant posterior colporrhaphy, POP-Q point Ap significantly improved and persisted at 34 months after surgery. Ten months after surgery, descent of POP-Q point Bp returned to preoperative levels and was the same regardless of whether a site-specific posterior colporrhaphy was performed at the time of an abdominal sacrocolpopexy.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Yau
authors.forename: David D
authors.initials: DD
authors.lastname: Rahn
authors.forename: Donald D
authors.initials: DD
authors.lastname: McIntire
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Schaffer
authors.forename: Clifford Y
authors.initials: CY
authors.lastname: Wai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000503:physiopathology* / Q000601:surgery