E-Posters-Site-Specific Repair of Posterior Vaginal Wall Prolapse: Long-term Efficacy

Site-Specific Repair of Posterior Vaginal Wall Prolapse: Long-term Efficacy - Jeffrey S. Schachar, MD

Pdf Summary

This study aimed to demonstrate the efficacy of combining apical site-specific repair and perineoplasty for posterior vaginal wall prolapse. The researchers conducted a retrospective review of a database, including patients who underwent reconstructive surgery for posterior compartment prolapse with at least 40 weeks of follow-up. The repair technique involved identifying and repairing site-specific tears in the posterior apical fibromuscular layer using three interrupted permanent sutures. The repair was completed with a midline plication perineoplasty. The outcomes were assessed subjectively (global impression scale) and objectively (POP-Q measurement). The study included 190 patients, with an average follow-up of 2.6 years. The subjective failure rate was 9.5%, with only two patients experiencing a vaginal bulge. The objective failure rate was 2.6%, and the composite failure rate was 0.5%. Eight patients (4.2%) required retreatment, with one experiencing posterior compartment failure. Smokers had a higher rate of subjective failure. The study concluded that the described repair technique using permanent sutures was highly effective for patients with transverse apical defects in the posterior compartment. There was no significant change in dyspareunia rates after surgery. The study provides evidence for the long-term efficacy of this site-specific repair technique for posterior vaginal wall prolapse.

Keywords

efficacy

apical repair

perineoplasty

posterior wall prolapse

retrospective review

permanent sutures

subjective outcomes

objective outcomes

failure rate

long-term efficacy