title: Operation for recurrent cystocele with anterior colporrhaphy or non-absorbable mesh: patient reported outcomes.
abstract: OBJECTIVE
  The aim of this study was to compare patient reported outcomes and complications after repair of recurrent anterior vaginal wall prolapse in routine health care settings using standard anterior colporrhaphy or non-absorbable mesh.
  
  
  METHODS
  The study is based on prospective data from the Swedish National Register for Gynaecological Surgery. 286 women were operated on for recurrent anterior vaginal wall prolapse in 2008-2010; 157 women had an anterior colporrhaphy and 129 were operated on with a non-absorbable mesh. Pre-, and perioperative data were collected from doctors and patients. Patient reported outcomes were evaluated 2 months and 12 months after the operation.
  
  
  RESULTS
  After 12 months, the odds ratio (OR) of patient reported cure was 2.90 (1.34-6.31) after mesh implants compared with anterior colporrhaphy. Both patient- and doctor-reported complications were found more often in the mesh group. However, no differences in serious complications were found. Thus, an organ lesion was found in 2.3% after mesh implant compared with 2.5% after anterior colporrhaphy (p = 0.58). Two patients in the mesh group (1.2%) were re-operated compared with 1 patient (0.6%) in the anterior colporrhaphy group (p = 0.58). The infection rate was higher after mesh (8.5%) than after anterior colporrhaphy (2.5%; OR 3.19 ; 1.07-14.25).
  
  
  CONCLUSIONS
  Implantation of synthetic mesh during operation for recurrent cystocele more than doubled the cure rate, whereas no differences in serious complications were found between the groups. However, mesh increased the risk of infection.
authors: Västerbottens County Council, The National Quality Register of Gynecological Surgery, Umeå, Sweden.
authors: Emil Karl
authors: EK
authors: Nüssler
authors: Susanne
authors: S
authors: Greisen
authors: Ulrik Schiøler
authors: US
authors: Kesmodel
authors: Mats
authors: M
authors: Löfgren
authors: Karl Møller
authors: KM
authors: Bek
authors: Marianne
authors: M
authors: Glavind-Kristensen
mesh_terms: D000368:Aged; D052858:Cystocele / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012042:Registries; D013526:Surgical Mesh / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
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