Effect of Cystocele Repair on Cervix Location in Women With Uterus In Situ

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Abstract

Introduction and Hypothesis

Our objective was to test the hypothesis that cystocele repair, in the absence of hysterectomy or apical suspension, results in higher cervix location in some women.

Methods

We performed a retrospective chart review of women with a uterus in situ who underwent native tissue anterior repair without hysterectomy/apical suspension from 2008 to 2014. Demographics, medical history, and preoperative and 6-week postoperative Pelvic Organ Prolapse Quantification System measurements were abstracted. Cervix location was defined by the clinic Pelvic Organ Prolapse Quantification System point C value. Women with higher (more negative) postoperative point C values were compared with those with a lower (more positive)/unchanged point C.

Results

Of the 33 women included, mean age was 59.8 ± 11.3 years. Median preoperative point C was −6.0 (interquartile range [IQR]: −6.75, −5.0) and point Ba was +2.0 (IQR: +0.5, +3.0). Point C was higher postoperatively in 21 (64%) of 33 women. Overall, point C was 1 cm higher post- versus preoperatively (−7.0 [IQR: −8.0, −6.0] vs −6.0 [IQR: −6.75, −5.0], P < 0.001) and point Ba was 4 cm higher (−2 [IQR: −3.0, −2.0] vs 2.0 [IQR: 0.5, 3.0], P < 0.001). Compared with women with lower/unchanged postoperative point C, those with higher point C were older (53.9 ± 12.3 vs 63.1 ± 9.4, P = 0.02) with lower parity (3.0 [IQR: 2.0, 3.0] vs 2.0 [IQR: 2.0, 3.0], P = 0.028).

Conclusions

The test of our hypothesis shows that in certain women with cystocele, anterior repair alone may be associated with higher cervix location 6 weeks postoperatively.

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