Long-term outcomes of laparoscopic repair of cystocoele.
BACKGROUND
There is little information on the effectiveness of laparoscopic techniques for native tissue repair of cystocoele.


OBJECTIVE
To assess the long-term outcome of laparoscopic cystocoele repair.


METHODS
Two hundred and twenty-three women with symptomatic pelvic organ prolapse underwent laparoscopic paravaginal repair and treatment of associated conditions. Women were assessed pre-operatively and postoperatively at 6 weeks, 6 months, 12 months and then annually or biannually with pelvic organ prolapse quantification (POPQ) and subjective assessment at each visit.


RESULTS
Median follow-up was 5.2 years (range: 1-12 years) with 140 women (63%) followed for at least 5 years. During follow-up, 79% of women developed prolapse of at least POPQ stage 2 in one or more compartments and 58% became symptomatic again. Overall, 48% underwent further prolapse surgery, but only 24% of women had an anterior prolapse beyond the hymen. Thirty per cent eventually had a further cystocoele repair.


CONCLUSIONS
Long-term follow-up of laparoscopic cystocoele repair shows that cystocoeles are difficult to repair successfully.
Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia.
Nicholas D
ND
Bedford
Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia.
Elvis I
EI
Seman
Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia.
Robert T
RT
O'shea
Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia.
Marc J N C
MJ
Keirse
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052858:Cystocele / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
cystocoele; laparoscopy; paravaginal; pelvic floor repair; prolapse