title: Anatomic and functional outcomes of sacrocolpopexy with or without posterior colporrhaphy.
abstract: OBJECTIVE
  The optimal surgery for combined apical and posterior vaginal prolapse is not well defined. Our objective was to examine the anatomic and functional outcomes following sacrocolpopexy (SCP) with or without posterior colporrhaphy (PC).
  
  
  METHODS
  We retrospectively evaluated 258 women who underwent abdominal (n = 62) or laparoscopic (n = 196) SCP with or without PC. Preoperative anatomic support and standardized bowel symptoms were compared to 6-week and 1-year postoperative values, using Student's t test and Wilcoxon rank sum test, respectively.
  
  
  RESULTS
  Six-week follow-up data were available for 235 of 258 (91.1 %) women, while 125 of 258 (48.4 %) women had 1-year anatomic and functional outcomes recorded. While the SCP + PC group had worse posterior descent and bowel function preoperatively, there were no significant differences in postoperative anatomic support or symptoms. Long-term pelvic floor function was similar, as measured by three validated instruments. Reduction in the proportion of women with splinting was greater in the SCP + PC group.
  
  
  CONCLUSIONS
  SCP with or without PC is associated with improved posterior support and decreased obstructive and irritative bowel symptoms at 1 year in women with apical and posterior prolapse.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital/Massachusetts General Hospital, Harvard Medical School, 75 Francis Street, ASB-3, Boston, MA 02115, USA. dkaser@partners.org
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Kaser
authors.forename: Erron L
authors.initials: EL
authors.lastname: Kinsler
authors.forename: Todd A
authors.initials: TA
authors.lastname: Mackenzie
authors.forename: Paul
authors.initials: P
authors.lastname: Hanissian
authors.forename: Kris
authors.initials: K
authors.lastname: Strohbehn
authors.forename: James L
authors.initials: JL
authors.lastname: Whiteside
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D003248:Constipation / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D019529:Sexuality; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014596:Uterine Prolapse / Q000150:complications / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000473:pathology / Q000601:surgery*