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A Prospective Study of Minimally Invasive Paravaginal Repair of Cystocele and Associated Pelvic Floor Defects: Our Experience

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Abstract

Aims and objectives

To assess the outcome of minimally invasive paravaginal repair of symptomatic cystocele and to correlate postoperative outcome with preoperative presentation. The primary outcome was the anatomical outcome measured by postoperative physical examination and the functional outcome was assessed by subjective symptoms and questionnaires. The secondary outcomes were perioperative and postoperative complications.

Materials and methods

In this longitudinal prospective observational study, 44 women underwent laparoscopic or robotic paravaginal cystocele repair from January 2016 to July 2016 and they were followed up to 1 year after surgery in a tertiary advanced laparoscopic center. All patients had a symptomatic lateral cystocele ≥ grade 2 according to Baden–Walker classification. Other coexisting defects like apical cystocele or combined defects were corrected concomitantly. The anatomical outcome was measured by physical examination and functional outcome was assessed by questionnaires—Pelvic Organ Prolapse Distress Inventory 6 and Urinary Distress Inventory 6 preoperatively and during postoperative follow-up.

Results

All 44 patients were followed up to 12 months after surgery. The anatomical cure rate for cystocele was 97.7%. There were no major complications. All subjective symptoms and quality of life scores improved significantly during postoperative follow-up. The anatomical recurrence rate in our study was 2.3%.

Conclusion

Minimally invasive paravaginal repair of cystocele is an effective advanced laparoscopic procedure. It can be concomitantly performed with other surgical procedures to correct coexisting defects. The anatomical and functional results were outstanding with minimum perioperative morbidity and encouraging long-term outcome.

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Authors and Affiliations

  1. Department of Endogynecology, Gem Hospital and Research Centre, 45A, Pankaja Mills Road, Ramanathapuram, Coimbatore, Tamil Nadu, 641045, India

    Kavitha Yogini Duraisamy, Devi Balasubramaniam, Amrutha Kakollu, Palanivelu Chinnusamy & Kodeeswari Periyasamy

Authors
  1. Kavitha Yogini Duraisamy
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  2. Devi Balasubramaniam
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  3. Amrutha Kakollu
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  4. Palanivelu Chinnusamy
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  5. Kodeeswari Periyasamy
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Corresponding author

Correspondence to Kavitha Yogini Duraisamy.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Dr. Kavitha Yogini Duraisamy, M.S., Fellow in Endogynecology, FMAS, is the Head of Department at Department of Endogynecology, Gem Hospital and Research Center, Coimbatore, Tamil Nadu, India. Dr. Devi Balasubramaniam, M.S., Fellow in Endogynecology, FMAS, is a senior Consultant at Department of Endogynecology, Gem Hospital and Research Center, Coimbatore, Tamil Nadu, India. Dr. Amrutha Kakollu, M.S., is a Fellow at Department of Endogynecology, Gem Hospital and Research Center, Coimbatore, Tamil Nadu, India. Dr. Palanivelu Chinnusamy, M.S, MCh, DNB, FACS, FRCS(Hon) Ed., is a Director at Gem Hospital and Research Center, Coimbatore, Tamil Nadu, India. Dr. Kodeeswari Periyasamy, M.S., Fellow in Endogynecology is a Consultant at Gem Hospital and Research Center, Coimbatore, Tamil Nadu, India.

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Duraisamy, K.Y., Balasubramaniam, D., Kakollu, A. et al. A Prospective Study of Minimally Invasive Paravaginal Repair of Cystocele and Associated Pelvic Floor Defects: Our Experience. J Obstet Gynecol India 69, 82–88 (2019). https://doi.org/10.1007/s13224-018-1137-1

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  • DOI: https://doi.org/10.1007/s13224-018-1137-1

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