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. 2012 Jan;23(1):65-71.
doi: 10.1007/s00192-011-1524-y. Epub 2011 Aug 6.

Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study

Mirjam Weemhoff  1 , Tineke F M Vergeldt, Kim Notten, Jan Serroyen, Paul H N M Kampschoer, Frans J M E Roumen
Affiliations

Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study

Mirjam Weemhoff et al. Int Urogynecol J. 2012 Jan.

Abstract

Introduction and hypothesis: This study aimed to determine the relationship of recurrent cystocele with avulsion of puborectalis muscle and other risk factors.

Methods: In this prospective observational cohort study, 245 women undergoing anterior colporrhaphy were invited for a 2-year follow-up visit consisting of a questionnaire, physical examination, and translabial 3D ultrasonography. Women with and without recurrent cystocele were compared to identify recurrence risk factors.

Results: Of the 245 women, 156 agreed to the follow-up visit (63.7%). Objective recurrence rate was 80 of 156 (51.3%). Seventeen of the 156 (10.9%) reported subjective recurrence. Risk factors for anatomical recurrence were complete avulsion of puborectalis muscle (OR, 2.4; 95% CI, 1.3, 4.7), advanced preoperative stage (OR, 2.0; 95% CI, 1.0, 4.1), family history of prolapse (OR, 2.4; 95% CI, 1.2, 4.9), and sacrospinous fixation (OR, 6.5; 95% CI, 2.0, 21.2).

Conclusions: Risk factors for anatomical cystocele recurrence after anterior colporrhaphy were complete avulsion of puborectalis muscle, advanced preoperative stage, family history of prolapse, and sacrospinous fixation.

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Figures

Fig. 1
Fig. 1
3D ultrasonography of levator muscle. 3D ultrasonography. Right side the mid-sagittal plane, left side the rendered 3D volume of the levator ani muscle. Normal insertion of the puborectalis muscle, no avulsion. 1 Bladder, 2 urethra, 3 central axis of symphysis, 4 anal canal, 5 levator muscle, 6 urethra, 7 vagina, 8 anal canal, 9 levator sling
See this image and copyright information in PMC

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