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- Title
Site-specific prolapse surgery. I. Reliability and durability of native tissue paravaginal repair.
- Authors
Reid, Richard I.; Hui You; Kehui Luo
- Abstract
Introduction and hypothesis: This study aims to compare native tissue abdominal and vaginal paravaginal repair, and to investigate whether surgical outcome was independent of operative route. Methods: Retrospective comparison of 111 displacement cysto-urethrocoeles, repaired between 1997 and 2007. Treatment was by surgeon assignment, 52 women having abdominal (APVR) and 59 vaginal paravaginal repairs. Main outcome measures were same-site prolapse recurrence, time to failure and surgical complications. Initial reliability was evaluated by chi-square test, 10-year durability by Kaplan-Meier survival analysis and Cox proportional hazards model. Results: When examined in the Cox proportional hazards model, anatomic results of APVR were more durable than a mechanically analogous transvaginal operation done [95% CI = 1.029-2.708 ( p value = 0.038)]. Kaplan-Meier curves plateaued within 38 months. Symptom resolution was broadly equivalent. Surgical complication rate was 3.6%. Conclusions: Site-specific re-suture of torn native tissue has genuine curative potential. Most of the long-term success was attributable to site-specific repair, rather than non-specific scar formation.
- Subjects
PROLAPSE of bodily organs; TISSUES; VAGINAL surgery; SURGICAL complications; OPERATIVE surgery
- Publication
International Urogynecology Journal, 2011, Vol 22, Issue 5, p591
- ISSN
0937-3462
- Publication type
Article
- DOI
10.1007/s00192-010-1347-2