Cystocele and rectocele repair with native tissue layers: definition of the technique

To investigate the outcomes of central cystocele and rectocele repair using natural tissue layers. To describe a novel technique (Dogan technique).

This is a retrospective cohort study. Between January 2021 and January 2023, patients who had central cystocele and rectocele higher than stage1 were included in the study. The Pelvic Organ Prolapse Quantification (POP-Q) score was used to determine the degree of the prolapsus. All cystocele and rectocele repair surgeries were performed by the same physician. The patients' voiding habits were assessed using ICIQ-SF and OAB-V8. Sexual function results were assessed with FSFI questionnaire before and after the operation. Transperineal ultrasonography was performed to examine mobility of the anterior and posterior compartments.

Total of 36 patients were diagnosed with grade 2 and above central cystocele (19, 52%) and rectocele (n = 17, 48%). After the operation the anatomical cure of anterior and posterior compartments was achieved for all patients in the two-years follow-up. According to voiding habits before the surgery, there were symptoms of stress urinary incontinence (SUI),urge urinary incontinence (URGE), both SUI and URGE, and no incontinence at the patients; 7 (36.8%), 14 (73.7%), 5 (26.3%), 3 (15.7%) respectively. Of those URGE patients (n = 5/14, 35.7%) incontinence symptoms were mixed-type. After the cystocele operation, significant improvement was seen in their voiding problems according to the ICIQ-SF and OAB-V8 questionnaires (p < 0.05). As well as significant improvement was found in sexual function according to the FSFI questionnaire (p < 0.05).

We showed that strengthening the anterior and/or posterior compartments with native tissue improves urge and voiding dysfunctions via a novel technique (Dogan technique) without removing the vagina tissue.