Cystocele repair by autologous rectus fascia graft. The Pubovaginal Cystocele Sling - Abstract

PURPOSE: The autologous rectus fascia pubovaginal sling has been a safe and effective means of correcting stress urinary incontinence (SUI).

In this study we tested the feasibility of using a larger graft for correcting cystocele with or without SUI.

MATERIALS AND METHODS: between January 2006 and October 2010, thirty patients with symptomatic cystocele underwent the Pubovaginal Cystocele Sling (PCS) procedure; 14 were with concomitant SUI and 16 without. The technique is a modification of the standard pubovaginal sling procedure. A large trapezoidal (major base 6cm, minor base 4cm, height 5cm) rectus fascia graft is used, with four instead of two sutures to suspend the graft corners. The two sutures at the level of mid urethra are tied above rectus muscles in a tension-free manner, whereas the two at the level of the cervical fold are tied with tension. Data on anatomical outcomes (Baden-Walker classification), functional outcomes (Pelvic Floor Impact Questionnaire, PFIQ-7-short form), postvoid residual urine volume (PVR), and urinary tract infection (UTI) were prospectively collected.

RESULTS: At mean follow-up of 62.6 months (range 46-98 months), there was no recurrence in anterior compartment but one involving both apical and posterior compartments. All patients reported a statistically significant improvement in PFIQ-7 score. When present preoperatively, PVR, UTI, and SUI ceased in all cases. There was only one complication, a donor-site wound dehiscence without fascial involvement.

CONCLUSIONS: The autologous PCS seems to be a safe and effective technique for correcting cystocele, with or without SUI.

Written by:
Cormio L, Mancini V, Liuzzi G, Lucarelli G, Carrieri G.   Are you the author?
Department of Urology and Renal Transplantation, University of Foggia, Italy.  

Reference: J Urol. 2015 Mar 30. pii: S0022-5347(15)03633-2.
doi: 10.1016/j.juro.2015.03.104

PubMed Abstract
PMID: 25837536 Trauma & Reconstruction Section

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