Wong, V., Shek, K., Rane, A., Goh, J., Krause, H., and Dietz, H.P. (2013) Is levator avulsion a predictor of cystocele recurrence following anterior vaginal mesh placement? Ultrasound in Obstetrics and Gynecology, 42 (2). pp. 230-234.

PDF (Published Version) - Published Version Restricted to Repository staff only

 

41

1

Abstract

Objective: Levator avulsion has been shown to be a predictor of cystocele recurrence following anterior colporrhaphy. The aim of this study was to determine if levator avulsion is a risk factor for prolapse recurrence following anterior colporrhaphy with mesh.

Methods: This was a retrospective analysis of data obtained from three surgical audits for subjective and objective outcomes following anterior colporrhaphy with mesh. Recurrence was defined as cystocele ≥ Stage 2 on the prolapse quantification system of the International Continence Society; symptoms of vaginal lump/bulge; or cystocele on ultrasound, defined as maximum bladder descent to ≥ 10 mm below the symphysis pubis. Levator avulsion was diagnosed using tomographic ultrasound imaging.

Results: Two hundred and nine patients were followed up at a mean of 2.2 years (range, 3  months to 5.6 years) after anterior vaginal mesh placement. 24% (51/209) had recurrent prolapse symptoms, 33% (68/209) clinical cystocele recurrence ≥ Stage 2, and 26% (54/209) a recurrent cystocele on ultrasound. Twenty-eight out of 80 (35%) women with levator avulsion had significant sonographic cystocele recurrence (odds ratio (OR), 2.24 (95% confidence interval (CI), 1.13–4.43)). This finding was confirmed after adjusting for potential predictors of prolapse recurrence on multivariate logistic regression (OR, 2.13 (95% CI, 1.04–4.39); P = 0.04).

Conclusion: Levator avulsion doubles the risk of cystocele recurrence after anterior colporrhaphy with transobturator mesh.

Actions (Repository Staff Only)

Item Control Page