Tecidos nativos na correção de defeitos de compartimento – casuística de 5 anos

Overview and Aims

Currently, the use of mesh in surgery for pelvic organ prolapse has increased, mainly due to the high anatomic failure rate of native tissues repair. The objectives of this study were to analyze the results obtained in the surgical treatment of anterior and posterior defects with native tissues and assess the success rate.

Methods

Retrospective study of 418 vaginal surgeries to repair defects in the anterior and posterior compartments using native tissues, performed in the Department of Urogynecology, from January 2008 to December 2012.

Results

In our sample, mean age was 64 years, with 90% of patients in menopause. 48.1% of women was hysterectomized, 78.2% were submitted to anterior colporrhaphy and 72.7% to posterior colporrhaphy. The correction of anterior paravaginal defect occurred in 32.5% of the surgeries and the posterior in 25.4%. Enterocele was repaired in 68.1% of cases. The intra‐operative and postoperative complications rate was 5%. Of the 347 patients evaluated in the postoperative period, 91.6% was discharged. Seven were later readmitted (2.2%). 29 women were kept in surveillance, mostly for recurrent prolapse, which worsened after a year of follow‐up. A total of 18 women was re‐operated, 13 for recurrence (3.7%). Therefore, the anatomic success rate was 80%. After adding the asymptomatic cases, in which anatomic cure was not achieve, the rate rose to 94%.

Discussion/Conclusions

The compartment defects correction rate of success, in our department, is in accordance with that described in the literature, with lower rates of complications and re‐interventions.