DUGSNyt nr.2 /2013 - Dansk Urogynækologisk Selskab

AbstractAf CH Buch; M Glavind-Kristensen;S Axelsen; KM Bek; S GreisenSubjective and objective results of anterior vaginalwall repair A 10-year prospective follow-up study23Objective Abstract AbstractAt follow-up twenty women (50%)To evaluateAf CH Buch;theAf M CHlongGlavind‐Kristensen; Buch;termM Glavind‐Kristensen;outcomeS Axelsen;ofKM S Axelsen; Bek;hadS Greisen KMstageBek; S1,Greisen13 (32%) had stage 2conventional surgical repair of anterior and one (3%) had stage 3 POP. Sixvaginal wall Subjective prolapse. Subjective and objective and objective results women results of anterior (15%) of anterior had vaginal been vaginal wall reoperated repair wall repairA 10-year A 10-year prospective due prospective to follow-up recurrence follow-up study (figure 1). studyMethodsBefore surgery 93% reported bulgesymptoms. Ten years postoperative-From January 1998 until NovemberObjective Objective2000, To 72 evaluate women To the evaluate long were term the operated outcome long term of outcome conventional with of conventional ly, surgical 65% repair had surgical of no anterior repair bulge vaginal of anterior symptoms, wall vaginal prolapse. wall and prolapse.primary anterior vaginal wall repair 20% still had bulge symptoms once ausing local anaesthesia in an outpatientFrom clinic. January At From follow-up 1998 January until November 1998 the until women November 2000, 72 women 2000, ment 72 were women 74% operated were of with operated the primary women with anterior primary consideredvaginal anterior wall vaginal repair wall rmonth or more. In an overall assess-Methods Methodswere using offered local anaesthesia clinical examination, an outpatient and clinic. At follow-up themselves women better were or offered much clinical better examination, after andfilled in a symptom- filled in a and symptom- quality and of life quality questionnaire. of life questionnaire.filled in a and quality of life surgery (figure 2).questionnaire.Results ResultsConclusionsFollow-up was Follow-up 10 years. was Forty 10 years. (56%) Forty women (56%) participated, women participated, (18 (25%) had (18 (25%) died, and had 10 died, (14%) and were 10 (14%) lost to were lostResultsAt 10 year follow-up, 65% was relievedfrom their bulge symptoms, andfollow-up). follow-up). Median age Median was 67 age (37-86) was 67 years, (37-86) median years, BMI median was 26 BMI (19-36). was 26 (19-36).Follow-up was 10 years. Forty (56%)women At baseline, participated, At 72% baseline, had stage 72% (182 had (25%) (POP) stage and 2 had (POP) 28% stage and 74% 28% 3. stage still considered 3. themselves betterdied,Atandfollow-up10At twenty(14%)follow-up womenweretwenty (50%)lostwomen hadto(50%) stagefol-1low-up). Median age was 67 (37-86) ration. However, 15% of the womenhad 13 stage (32%)or much1, had 13 (32%) stagebetter2 had and stagethanone (3%) 2 andbeforehad one stage (3%)the3 had POP.ope-stage Six 3 POP.women (15%) women had (15%) been reoperated had been reoperated due to recurrence due to recurrence (figure 1). (figure 1).years, Before median surgery Before BMI 93% surgery was reported 26 93% bulge (19-36). reported symptoms. bulge symptoms. Ten had years been postoperatively, Ten years reoperated postoperatively, 65% had and no 65% bulge 20% had symptoms, no still bulge symptom andAt 20% baseline, still had 20% bulge still 72% symptoms had bulge had symptoms once stage a month once 2 or a more. month experienced In or an more. overall In assessment an bulge overall symptoms assessment 74% of the 74% women once of the a womenconsidered considered themselves themselves better or much better better or much after better surgery after (figure surgery 2). (figure 2).(POP) and 28% stage 3.month or moreusing local anaesthesia in an outpatient clinic. At follow-up the women were offered clinical examinationFigure 1: Figure Anatomical 1: Anatomical Figure results 1: Anatomical 10 results year10 results year at 10 year Figure Figure 2: Subjective 2: Figure 2: Subjective results at 10 results yearat 10 yearfollow-up follow-up after anterior after follow-up vaginal anterior after wall vaginal anterior repair wall vaginal repair wall follow-up repair follow-up after follow-up after anterior anterior after vaginal anterior wall vaginal repairwall repair5045403530252015105050454035302520151050stage 1 stage stage 2 stage 1 stage 3 reop 2 stage 3 reop706050403020100706050403020100no bulge no bulge bulge reop bulge improved reop improvedConclusions Conclusions26 At 10 year At follow-up, 10 year 65% follow-up, was relieved 65% was from relieved their bulge from their symptoms, bulge symptoms, and 74% still and considered DUGSNyt 74% still nr. considered themselves 2 . 2013 themselvebetter or much better better or much than better before than the operation. before the However, operation. 15% However, of the 15% women of the had women been reoperated had been reoperated and 20% and