E-Posters-Transvaginal Repair of Pelvic Organ Prolapse after Cystectomy/Anterior Pelvic Exenteration

Transvaginal Repair of Pelvic Organ Prolapse after Cystectomy/Anterior Pelvic Exenteration - Iryna M. Crescenze, MD

Pdf Summary

This study aimed to describe the experience with transvaginal repair of pelvic organ prolapse (POP) after cystectomy and/or anterior pelvic exenteration. The study involved a single center retrospective review of patients who had undergone prior cystectomy and presented for POP repair. The primary outcome was symptomatic recurrence of POP and the secondary outcomes included surgical complications and functional outcomes.<br /><br />The study included 10 patients who underwent transvaginal repair of POP after cystectomy/anterior pelvic exenteration. The indication for cystectomy was bladder cancer in 9 out of 10 patients. The most common presenting complaints were bulge, pain, and vaginal discharge.<br /><br />The results showed that at an average follow-up of 16.0+/-16.7 months, 3 out of 10 patients had symptomatic recurrence of POP. These patients had the leading edge of the prolapse at or above the hymen. One patient underwent repeat repair.<br /><br />Complications were observed in 3 out of 10 patients, including enterotomy, biologic mesh extrusion requiring removal, and vaginal bleeding managed conservatively. The study reported a 70% long-term success rate for transvaginal repair of POP after cystectomy/anterior pelvic exenteration.<br /><br />It is important to note that there is a risk for bowel injury associated with this approach due to adhesions from prior pelvic surgery, so a high index of suspicion should be maintained during dissection to identify and repair any injuries.<br /><br />In conclusion, transvaginal repair of POP after cystectomy/anterior pelvic exenteration is a feasible and effective treatment option with a 70% long-term success rate. This study provides valuable insights into the outcomes and complications of this approach.

Keywords

transvaginal repair

pelvic organ prolapse

cystectomy

anterior pelvic exenteration

symptomatic recurrence

surgical complications

functional outcomes

bladder cancer

biologic mesh extrusion

long-term success rate