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Cystocele Repair by Autologous Rectus Fascia Graft: the Pubovaginal Cystocele Sling.
J Urol. 2015 Sep; 194(3):721-7.JU

Abstract

PURPOSE

The autologous rectus fascia pubovaginal sling has been a safe and effective means of correcting stress urinary incontinence. We tested the feasibility of using a larger graft to correct cystocele with or without stress urinary incontinence.

MATERIALS AND METHODS

Between January 2006 and October 2010, 30 patients with symptomatic cystocele underwent the pubovaginal cystocele sling procedure, including 14 with and 16 without concomitant stress urinary incontinence. The technique is a modification of the standard pubovaginal sling procedure. A large trapezoidal (major base 6 cm, minor base 4 cm and height 5 cm) rectus fascia graft is used with 4 instead of 2 sutures to suspend the graft corners. The 2 sutures at the level of the mid urethra are tied above the rectus muscles in a tension-free manner while the 2 sutures at the level of the cervical fold are tied with tension. Data on anatomical outcomes (Baden-Walker classification), functional outcomes (PFIQ-7), post-void residual urine volume and urinary tract infection were prospectively collected.

RESULTS

At a mean followup of 62.6 months (range 46 to 98) there was no recurrence in the anterior compartment. There was 1 recurrence involving the apical and posterior compartments. All patients reported a statistically significant improvement in PFIQ-7 score. When present preoperatively, post-void residual urine volume, urinary tract infection and stress urinary incontinence ceased in all cases. The only complication was donor site wound dehiscence without fascial involvement.

CONCLUSIONS

The autologous pubovaginal cystocele sling seems to be a safe, effective technique to correct cystocele with or without stress urinary incontinence.

Authors+Show Affiliations

Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy. Electronic address: luigicormio@libero.it.Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy.Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy.Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy.Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25837536

Citation

Cormio, Luigi, et al. "Cystocele Repair By Autologous Rectus Fascia Graft: the Pubovaginal Cystocele Sling." The Journal of Urology, vol. 194, no. 3, 2015, pp. 721-7.
Cormio L, Mancini V, Liuzzi G, et al. Cystocele Repair by Autologous Rectus Fascia Graft: the Pubovaginal Cystocele Sling. J Urol. 2015;194(3):721-7.
Cormio, L., Mancini, V., Liuzzi, G., Lucarelli, G., & Carrieri, G. (2015). Cystocele Repair by Autologous Rectus Fascia Graft: the Pubovaginal Cystocele Sling. The Journal of Urology, 194(3), 721-7. https://doi.org/10.1016/j.juro.2015.03.104
Cormio L, et al. Cystocele Repair By Autologous Rectus Fascia Graft: the Pubovaginal Cystocele Sling. J Urol. 2015;194(3):721-7. PubMed PMID: 25837536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cystocele Repair by Autologous Rectus Fascia Graft: the Pubovaginal Cystocele Sling. AU - Cormio,Luigi, AU - Mancini,Vito, AU - Liuzzi,Giuseppe, AU - Lucarelli,Giuseppe, AU - Carrieri,Giuseppe, Y1 - 2015/03/30/ PY - 2015/03/23/accepted PY - 2015/4/4/entrez PY - 2015/4/4/pubmed PY - 2015/11/13/medline KW - autografts KW - cystocele KW - prolapse KW - stress KW - urinary bladder KW - urinary incontinence SP - 721 EP - 7 JF - The Journal of urology JO - J Urol VL - 194 IS - 3 N2 - PURPOSE: The autologous rectus fascia pubovaginal sling has been a safe and effective means of correcting stress urinary incontinence. We tested the feasibility of using a larger graft to correct cystocele with or without stress urinary incontinence. MATERIALS AND METHODS: Between January 2006 and October 2010, 30 patients with symptomatic cystocele underwent the pubovaginal cystocele sling procedure, including 14 with and 16 without concomitant stress urinary incontinence. The technique is a modification of the standard pubovaginal sling procedure. A large trapezoidal (major base 6 cm, minor base 4 cm and height 5 cm) rectus fascia graft is used with 4 instead of 2 sutures to suspend the graft corners. The 2 sutures at the level of the mid urethra are tied above the rectus muscles in a tension-free manner while the 2 sutures at the level of the cervical fold are tied with tension. Data on anatomical outcomes (Baden-Walker classification), functional outcomes (PFIQ-7), post-void residual urine volume and urinary tract infection were prospectively collected. RESULTS: At a mean followup of 62.6 months (range 46 to 98) there was no recurrence in the anterior compartment. There was 1 recurrence involving the apical and posterior compartments. All patients reported a statistically significant improvement in PFIQ-7 score. When present preoperatively, post-void residual urine volume, urinary tract infection and stress urinary incontinence ceased in all cases. The only complication was donor site wound dehiscence without fascial involvement. CONCLUSIONS: The autologous pubovaginal cystocele sling seems to be a safe, effective technique to correct cystocele with or without stress urinary incontinence. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/25837536/Cystocele_Repair_by_Autologous_Rectus_Fascia_Graft:_the_Pubovaginal_Cystocele_Sling_ DB - PRIME DP - Unbound Medicine ER -