Laparoscopic paravaginal repair of anterior compartment prolapse.
OBJECTIVE
To assess the results of laparovaginal repair of anterior vaginal prolapse in terms of perioperative morbidity and repair durability.


METHODS
Longitudinal study of a consecutive series of women assessed with the pelvic organ prolapse quantification (POPQ) system before and after laparoscopic paravaginal repair of anterior vaginal prolapse (Canadian Task Force classification II-2).


METHODS
University hospital in South Australia.


METHODS
Two hundred twelve women undergoing laparoscopic paravaginal repair for anterior compartment prolapse, with average follow-up of 14.2 months and 10 (4.7%) lost to follow-up.


METHODS
All women underwent bilateral laparoscopic paravaginal repair that was combined with uterosacral hysteropexy or colpopexy in women with concomitant level I defects (n = 42) and supralevator repair in those with posterior fascia defects (n = 47). Recurrences were treated with graft-reinforced anterior colporrhaphy (n = 18).


RESULTS
Nine women (4.2%) had major complications, and there were 61 minor complications. The POPQ assessment on follow-up (mean 14.2 months) gave a prolapse cure of the laparoscopic repair of 76% (95% CI 70.7%-82.1%). Eighteen of 23 women with a residual central defect subsequently had a graft-reinforced anterior colporrhaphy, after a mean interval of 14 months, which increased the cure rate to 84% (95% CI 79.6%-89.3%).


CONCLUSIONS
Laparoscopic paravaginal repair followed by graft-reinforced anterior colporrhaphy for central defects, when necessary, is associated with a low morbidity rate and achieves an anatomic cure rate greater than 80%.
Behnia-Willison
Fariba
F
Department of Obstetrics, Gynecology and Reproductive Medicine, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia.
Seman
Elvis I
EI
Cook
Jennifer R
JR
O'Shea
Robert T
RT
Keirse
Marc J N C
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery