The natural history of posterior vaginal wall support after abdominal sacrocolpopexy with and without posterior colporrhaphy.
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.
Yau
Jane L
JL
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Rahn
David D
DD
McIntire
Donald D
DD
Schaffer
Joseph I
JI
Wai
Clifford Y
CY
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