Clinical observation of effect of modified vaginal paravaginal repair on pelvic floor reconstruction in 52 cases / 中华老年医学杂志

ABSTRACT

Objective To explore the efficacy and safety of modified vaginal paravaginal repair (VPVR) in treatment of symptomatic paravaginal defect cystocele(PDCC). Methods This study was an observational case series of 52 consecutive women in Beijing hospital from January 2007 to August 2009, with symptomatic paravaginal defect cystocele. Among them, 6 patients had anterior wall colporrhaphy. Preoperative and postoperative pelvic evaluations were performed with the POP-Q system. All the cases underwent vaginal approach to paravaginal repair, 49 cases underwent vaginal hysterectomy simultaneously. Patients were followed up for 1 to 24 months. Criteria for objective cure were defined as the anterior vaginal walls at grade 0 and firmly apposing to the lateral pelvic sidewalls.Results Of the 52 patients, 30 had grade Ⅱ , 17 had grade Ⅲ, and 5 had grade Ⅳ paravaginal defect cystocele. In all patients the VPVR was performed successfully. No complication happened during and after operation. The average operation time was (65 ±18) min (45-110 min) and estimated blood loss was (95 ± 27) ml (50-200 ml). Patients were followed up postoperatively for 3 to 24months, with a mean of (10. 1±3.1) months. The PDCC recurred in 6 cases, 5 patients had grade Ⅰcystocele and 1 had grade Ⅲ cystocele. Conclusions The vaginal approach to the correction of paravaginal defect cystocele is highly effective in our population.