Site-specific colporrhaphy in posterior compartment pelvic organ prolapse

INTRODUCTION AND HYPOTHESIS: A posterior vaginal wall prolapse is the result of specific tears in the rectovaginal fascia. The prevalence of the different defect types (superior, inferior, overstretching) is unknown, as is the subjective results after operation according to defect type. The aims of this retrospective study were to investigate the prevalence of the different injury sites and the subjective effects after an operation concerning the symptomatic feeling of a vaginal bulge and urinary incontinence in relation to defect types.

METHODS: Medical case records and data from the national Danish urogynecological database in patients with a prolapse operation including posterior vaginal wall prolapse for a 6-year period were reviewed. Four hundred and five patients were included. Patients completed the International Consultation on Incontinence-Urinary Incontinence Short Form and three questions on vaginal prolapse symptoms before and 3 months postoperatively.

RESULTS: The majority of women suffered from a superior defect (77 %). There was a statistically significant improvement in prolapse symptoms after surgery, with no difference between patients with different defect types. Patients with a superior defect and overstretching also experienced a statistically significant improvement in urinary incontinence.

CONCLUSIONS: The superior defect was the most common defect in the rectovaginal fascia. Patients experienced an improvement in subjective prolapse symptoms concerning the feeling of a vaginal bulge with no difference regarding defect type. Patients with a superior defect or overstretching experienced a statistically significant improvement in urinary incontinence. Similar results were found whether or not concomitant prolapse operations were performed in other compartments.