The Early Experience of Sling Procedure Used Remnant Anterior Vaginal Wall Tissue with Grade III Cystocele

Jeong, Tae Yung; Lee, Kyung Gu; Lee, Sang Ik

Abstract

PURPOSE: In patient with grade III cystocele, to determine whether the anterior vaginal wall tissue, remnant at the anterior colporrhaphy, is an appropriate sling material, we retrospectively reviewed the outcomes of sling operations that used remnant anterior vaginal wall tissue.
MATERIALS AND METHODS
An anterior colporrhaphy and sling operation using remnant vaginal wall tissue was undertaken in 21 patients. The preoperative evaluation included the patients' history, a physical examination, urinalysis, an urodynamic test, a voiding cystourethrogram and incontinence staging with Stamey grade. The surgical outcomes and stress- related leakage, emptying ability, anatomy, protection, inhibition (SEAPI) were assessed.
RESULTS
The mean follow-up period, operation time and hospital stay were 18 months (12-36), 45.4 minutes and 8.6 days, respectively. 18 patients (85.7%) were cured and 3 (14.3%) improved. The total subjective SEAPI score of 8.48 decreased postoperatively to 1.78. The pre- and post-operative complications were unremarkable.
CONCLUSIONS
The remnant anterior vaginal wall sling was helpful in minimizing the postoperative complications and cost effectiveness. Although long-term follow-up data might be required, this technique could be a good alternative method to replace conventional fascial or synthetic pubovaginal slings with grade III cystocele.