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Fascial Posterior Colpoperineorrhaphy: A Five Year Follow-Up Study

Robinson, Dudley MRCOG; Wadsworth, Sarah MRANZCOG; Cardozo, Linda MD, FRCOG; Bidmead, John MRCOG; Balmforth, James MRCOG

Journal of Pelvic Medicine and Surgery: November-December 2003 - Volume 9 - Issue 6 - p 279-283
doi: 10.1097/01.spv.0000103950.44439.be
Original Article

Objective: To determine the effect of fascial posterior colpoperineorrhaphy on bowel and sexual function.

Methods: A retrospective observational study of women undergoing fascial colpoperineorrhaphy over a five-year period in a tertiary referral urogynecology unit. At follow up all women completed structured questionnaires and 34 (57%) of the women returned for clinical examination.

Results: 80 women were identified who had undergone posterior colpoperineorrhaphy alone of whom 60 (75%) were available for analysis. Mean age was 55.8 years (range 32–86) and mean duration of follow up was 41 months (range 19–77). 34 women (57%) returned and were examined. Postoperatively prolapse symptoms due to rectocele decreased (88% versus 32%). Symptoms of vaginal pain (38% versus 17%), dyspareunia (33% versus 10%) vaginal laxity (25% versus 8%) and digitation to defecate (30% versus 10%) were all significantly reduced. However there was no significant difference in sexual activity (57% versus 45%), constipation (40% versus 37%), faecal incontinence (20% versus 17%) or troublesome lower urinary tract symptoms (52% versus 38%).

Conclusion: Successful correction of posterior vaginal wall prolapse is possible using a fascial posterior colpoperineorrhaphy, leading to a significant improvement in symptoms of prolapse and dyspareunia without any deterioration in bowel or bladder function, suggesting that this technique may be superior to a standard conventional posterior vaginal wall repair.

Successful correction of posterior vaginal wall prolapse is possible using a fascial posterior colpoperineorrhaphy, leading to a significant improvement in symptoms of prolapse and dyspareunia without any deterioration in bowel or bladder function.

From the Department of Urogynaecology, King's College Hospital, London, United Kingdom.

Reprints: Linda Cardozo, 8 Devonshire Place, London, UK W1G 6HP. E-mail: lcardozo@compuserve.com

© 2003 Lippincott Williams & Wilkins, Inc.