title: Nine-year objective and subjective follow-up of the ultra-lateral anterior repair for cystocele.
abstract: OBJECTIVE
  The aim of this study was to determine the long-term objective and subjective outcomes of the native tissue ultra-lateral anterior repair for cystocele.
  
  
  METHODS
  An observational study of patients from a single tertiary centre was carried out from January 1994 to December 2006. Patients who underwent an ultra-lateral anterior repair during this period were sent the Pelvic Floor Distress Inventory (PFDI) questionnaire and invited to return for a POP-Q examination. Symptoms of prolapse, stage of cystocele recurrence and reoperation rate were assessed at follow-up.
  
  
  RESULTS
  Of the 135 patients recruited, 53 also had a POP-Q examination. Mean follow-up was 9.25 years (SD 3.2). The anatomical recurrence rate was 45 % at 9.25 years, but only 26 % of patients had recurrent prolapse symptoms. Most recurrences (43 %) occurred at between 1 and 5 years. The reoperation rate for cystocele was 7.4 %.
  
  
  CONCLUSIONS
  Despite these rates of anatomical and symptomatic recurrence, only 7.4 % of patients underwent repeat cystocele surgery. Thus, symptomatic/anatomical recurrence of prolapse often does not mandate surgical correction. Considering that mesh complications require surgical management in approximately 10–15 %, this study supports the notion that the use of mesh in anterior vaginal repairs to reduce the risk of “recurrence” needs careful discussion with each patient.
authors.forename: Zhuoran
authors.initials: Z
authors.lastname: Chen
authors.forename: Vivien
authors.initials: V
authors.lastname: Wong
authors.forename: Alex
authors.initials: A
authors.lastname: Wang
authors.forename: Kate H
authors.initials: KH
authors.lastname: Moore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D052858:Cystocele / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D053825:Suburethral Slings; D011795:Surveys and Questionnaires