Korean J Obstet Gynecol.  2007 Feb;50(2):329-336.

Comparison of anterior repair, anterior repair with prolene mesh and internal anterior repair for surgical treatment of the central type of anterior vaginal wall defects

Affiliations
  • 1Department of Obstetrics and Gynecology College of Medicine, Yonsei University, Seoul, Korea. swbai@yumc.yonsei.ac.kr

Abstract


OBJECTIVE
As for the method of surgical correlation of the central type of anterior vaginal wall defects, there are anterior repair, anterior repair with prolene mesh, and internal anterior repair. The object of this study was to compare the recurrence rates, complications and the clinical efficacy of the three surgical procedures.
METHODS
We identified one hundred and thirty-eight patients who underwent operations for the central type of anterior vaginal wall defects from March 1999 to May 2005. We retrospectively collected data from the medical records and reviewed the outcomes. We investigated the characteristics of patients, recurrence rates and complication rates for the results, and compared them by ANOVA test and Kruskal-Wallis test.
RESULTS
The number of cases of anterior repair, anterior repair with the mesh, and internal anterior repair were seventy-two, twenty-eight and thirty-eight consecutively. There was no significant difference in the characteristics of age, menopause status, parity, BMI (Body mass index) and history of pelvic surgery and the medico-surgical illness among the three groups. There were statistically no significant differences in fever, vaginal erosion, detrusor overactivity and voiding difficulty after the operations. The incidence of the postoperative urinary tract infections was increased significantly in the group of the anterior repair with prolene mesh (p=0.018), and drop in hemoglobin, operation time and wound infection were increased significantly in the group of the internal anterior repair (p=0.0001, 0.004 and p=0.028). The recurrence rate of the disease was significantly higher in internal anterior repair group than in anterior repair or anterior repair with the mesh groups (18.4% vs. 1.4% and 0%). The recurrence rate was increased in proportion to the duration after the surgery.
CONCLUSION
The recurrence rate of the disease after internal anterior repair was significantly higher than when anterior repair or anterior repair with the mesh was done. As for the complications, urinary tract infection was increased after the anterior repair with prolene mesh and drop in hemoglobin and wound infection were increased after the internal anterior repair. We concluded that the conventional anterior repair is more suitable method for the correction of the central type of anterior vaginal wall defects than anterior repair with mesh and internal anterior repair.

Keyword

Anterior wall defects; Anterior repair; Prolene mesh; Recurrence; Complication

MeSH Terms

Female
Fever
Humans
Incidence
Medical Records
Menopause
Parity
Polypropylenes*
Recurrence
Retrospective Studies
Urinary Tract Infections
Wound Infection
Polypropylenes
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