Native-tissue repair of isolated primary rectocele compared with nonabsorbable mesh: patient-reported outcomes

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Madsen, Lene Duch (author)

Native-tissue repair of isolated primary rectocele compared with nonabsorbable mesh : patient-reported outcomes

Article/chapterEnglish2017

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2016-07-05
Springer Science and Business Media LLC,2017
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LIBRIS-ID:oai:DiVA.org:umu-131088
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-131088URI
https://doi.org/10.1007/s00192-016-3072-yDOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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We evaluated patient-reported outcomes and complications after treatment of isolated primary rectocele in routine health-care settings using native-tissue repair or nonabsorbable mesh. We used prospective data from the Swedish National Register for Gynaecological Surgery and included 3988 women with a primary operation for rectocele between 2006 and 2014: 3908 women had native-tissue repair, 80 were operated with nonabsorbable mesh. No concurrent operations were performed. Pre- and perioperative data were collected from doctors and patients. Patient-reported outcomes were evaluated 2 and 12 months after the operation. Only validated questionnaires were used. One year after native-tissue repair, 77.8 % (76.4-79.6) felt they were cured, which was defined as never or hardly ever feeling genital protrusion; 74.0 % (72.2-75.7) were very satisfied or satisfied, and 84 % (82.8-85.9) reported improvement of symptoms. After mesh repair, 89.8 % (77.8-96.6) felt cured, 69.2 % (54.9-81.3) were very satisfied or satisfied, and 86.0 % (72.1-94.7) felt improvement. No significant differences were found between groups. Organ damage was found in 16 (0.4 %) patients in the native-tissue repair group compared with one (1.3 %) patient in the mesh group [odds ratio (OR) 3.08; 95 % confidence interval (CI) 0.07-20.30]. The rate of de novo dyspareunia after native-tissue repair was 33.1 % (30.4-35.8), comparable with that after mesh repair. The reoperation rate was 1.1 % (0.8-1.5) in both groups. Most patients were cured and satisfied after native-tissue repair of the posterior vaginal wall, and the patient-reported outcomes were comparable with results after mesh repair. The risk of serious complications and reoperation were comparable between groups.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reproduktionsmedicin och gynekologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Obstetrics, Gynaecology and Reproductive Medicine hsv//eng
Colporrhaphy
National register data
Non absorbable mesh
Patient-reported outcome
Rectocele

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Nüssler, EmilUmeå universitet,Obstetrik och gynekologi(Swepub:umu)emnu0003 (author)
Kesmodel, Ulrik Schioler (author)
Greisen, Susanne (author)
Bek, Karl Møller (author)
Glavind-Kristensen, Marianne (author)
Umeå universitetObstetrik och gynekologi (creator_code:org_t)

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In:International Urogynecology Journal: Springer Science and Business Media LLC28:1, s. 49-570937-34621433-3023

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