Very long-term follow-up of the anterior vaginal wall suspension procedure for incontinence and/or prolapse repair

Resection of anterior vaginal wall that occurs with some cases of anterior pelvic exenteration leaves the patient with a small and narrow vagina. This affects their sexual life leading to major psychologic problems, especially in young women. The aim of this study is to evaluate a new technique of vaginal reconstruction following anterior pelvic exenteration with clinical and cytohistologic follow-up. Between March 2002 and November 2004, ten sexually active female patients underwent vaginal reconstruction after radical cystectomy that required en bloc removal of the anterior vaginal wall, with a pedicle graft of greater omentum combined with a vicryl mesh. The mean age of the patients was 38 years. The mean operative time of the reconstructive procedure was 50 min. There were no complications regarding the reconstructive procedure. On follow-up, the neovagina accepted two fingers easily and showed a pink-colored smooth lining. Seven patients reported successful attempts of sexual intercourse. It was concluded that reconstruction of vagina after anterior pelvic exenteration in sexually active women can be done safely with the use of vicryl mesh combined with a pedicled omental graft. It is a simple, reliable, and not time-consuming technique. The long-term follow-up was very beneficial in detection of complete healing, postoperative infections, and hormonal activity of the graft and recurrence of malignancy.

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The Anterior Vaginal Wall Sling Operation for Female Stress Urinary Incontinence: long-term follow-up results

Journal of the Korean Continence Society ◽

10.5213/jkcs.2001.5.1.48 ◽

2001 ◽

Vol 5 (1) ◽

pp. 48

Author(s):

Je Hee Kim ◽

Hyeon Seok Yang ◽

Sang Lin Lee ◽

Hyeong Gon Kim ◽

Won Hee Park

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Female Stress Urinary Incontinence ◽

Vaginal Wall Sling ◽

Long Term Follow Up

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A modified vaginal wall patch sling technique for genuine stress incontinence: Long term follow up

Journal of the Society for Gynecologic Investigation ◽

10.1016/s1071-5576(97)86228-4 ◽

1998 ◽

Vol 5 (1) ◽

pp. 78A-78A

Author(s):

M MIKHAIL ◽

A ANYAEGBUNAM

Keyword(s):

Stress Incontinence ◽

Vaginal Wall ◽

Genuine Stress Incontinence ◽

Long Term Follow Up

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Modified Two-corner Raz Suspension Procedure for Cystocele Repair: A Novel Technique

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1402 ◽

2016 ◽

Vol 8 (2) ◽

pp. 130-135

Author(s):

Urmila Sharma ◽

Ritu Agarwal ◽

Nilesh L Goraniya ◽

Sumesh D Choudhary ◽

Pradeep J Bandwal ◽

...

Keyword(s):

Quality Of Life ◽

Stage Iv ◽

Anterior Wall ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Stage Ii ◽

Novel Technique

ABSTRACT Introduction Prolapse of anterior vaginal wall is a common problem in both perimenopausal and postmenopausal women. In past 200 years, surgical management of cystocele has undergone many changes from Kelly's plication to mesh reinforcement but none of these procedures proved to be 100% effective. Modified two-corner Raz suspension procedure (MTCRSP) can be used for the treatment of POP-Q (pelvic organ prolapse quantification) stage II to IV anterior vaginal wall prolapse (AVP). Objectives To assess the effectiveness of modified two-corner Raz suspension procedure (MTCRSP) in long-term success for cystocele repair and its effect on quality of life. Study design A hospital-based prospective study. Materials and methods Twelve patients underwent modified two-corner Raz procedure and were followed postoperatively for a period of 1 year at regular intervals. During follow-up, we assessed the degree of prolapse by POP-Q, quality of life, and sexual dysfunction. Results Preoperatively, 3 out of 12 (25%) patients had stage II, five had (41.66%) stage III, and four (33.33%) had stage IV prolapse. Postoperatively, at 1 month follow-up, one (8.33%) patient developed stage II anterior wall prolapse, which progressed to stage IV prolapse at 3 months. Two more patients developed stage II prolapse at 3-month follow-up. Failure rate at the end of 1 year was 25% (3/12). Prolapse quality of life (PQOL) improved in 10 out of 12 (83.33%) patients. While PGII (patient global impression of improvement) score improved in 11 out of 12 (91.66%) women. Conclusion Modified two-corner Raz suspension procedure is an effective technique with long-term success in stage II and III prolapse but a limited success in stage IV AVP. How to cite this article Mishra VV, Goraniya NL, Choudhary SD, Sharma U, Bandwal PJ, Tanvir T, Agarwal R. Modified Two-corner Raz Suspension Procedure for Cystocele Repair: A Novel Technique. J South Asian Feder Obst Gynae 2016;8(2):130-135.

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