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Midline fascial plication under continuous digital transrectal control: which factors determine anatomic outcome?
Alfredo L Milani1, Mariella I J Withagen, Karlijn J Schweitzer
1Department of Obstetrics and Gynaecology, Reinier de Graaf Group, PO Box 5011, 2600, GA Delft, The Netherlands. almilani@telfort.nl
Introduction And Hypothesis:
The aim of the study was to report anatomic and functional outcome of midline fascial plication under continuous digital transrectal control and to identify predictors of anatomic failure.
Methods:
Prospective observational cohort. Anatomic success defined as POP-Q stage
Results:
Two hundred thirty-three patients with posterior pelvic organ prolapse (POP) stage >or= II underwent midline fascial plication under continuous digital transrectal control. Median follow-up was 14 months (12-35 months), and anatomic success was 80.3% (95% CI 75-86). Independent predictors of failure were posterior compartment POP stage >or= III [OR 8.7 (95% CI 2.7-28.1)] and prior colposuspension [OR 5.6 (95% CI 1.1-27.8)]. Sixty-three percent of patients bothered by obstructed defaecation experienced relief after surgery.
Conclusions:
Anatomic and functional outcomes were good. Risk factors for anatomic failure were initial size of posterior POP (stage >or= III) and prior colposuspension.
