The natural history of cystocele recurrence

Female pelvic organ prolapse is a common condition, and recurrence after surgery is considered a significant clinical issue, especially in the anterior compartment. To the best of our knowledge, there are currently no published data in the literature on the timing of recurrence. We used data obtained in clinical audit projects and a prospective surgical trial to define the natural history of cystocele recurrence.

This is an observational retrospective study utilising data of 166 patients seen at least twice after anterior colporrhaphy, obtained from four clinical audit projects and one prospective surgical trial.

We identified a total of 481 postoperative visits at a mean follow-up of 1.11 years in 166 individuals. At last available follow-up, 80 (48%) had evidence of cystocele recurrence (ICS POP-Q stage 2+), and 44 (27%) reported symptoms of prolapse. Ultrasound evidence of cystocele recurrence was seen in 74 women (45%). Regression modelling demonstrated that the likelihood of recurrence was highest between 1 and 2 years' follow-up.

Cystocele recurrence after anterior colporrhaphy seems to be a relatively early phenomenon, with maximum prevalence reached at 18-24 months.