Introduction: We used quantitative parameters obtained during the voiding phase, urinary symptoms and sexual functioning to investigate the symptomatic and functional changes after cystocele repair with a polypropylene mesh. Patients and Methods: The maximum urinary flow rate (Qmax), residual urine (RU) volume and two symptom questionnaires, the Urinary Distress Inventory (UDI-6) and the Female Sexual Function Index (FSFI), were used to retrospectively evaluate 39 consecutive cystocele patients before and 6 months after surgery. Results: Qmax, RU and FSFI were not significantly different (p = 0.366, 0.286 and 0.100, respectively) pre- and postoperatively, but the UDI-6 score had significantly improved (p < 0.001) 6 months after the cystocele repair. A concomitant sling procedure was significantly correlated with changes in the UDI-6 score (p < 0.001); the patients without stress urinary incontinence (SUI) who underwent cystocele repair only showed no symptomatic improvements in the UDI-6 score (p = 0.560). Conclusions: Correction of SUI resulted in urinary symptom improvement in cystocele patients. Cystocele repair with or without sling placement did not change Qmax, RU or sexual functioning at the 6-month follow-up.

1.
Beck RP, McCormick S, Nordstrom L: A 25-year experience with 519 anterior colporrhaphy procedures. Obstet Gynecol 1991;78:1011–1018.
2.
Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A: Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol 2002;186:1160–1166.
3.
Fatton B, Amblard J, Debodinance P, Cosson M, Jacquetin B: Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (Prolift™ technique) – a case series multicentric study. Int Urogynecol J 2007;18:743–752.
4.
Letouzey V, Deffieux X, Gervaise A, Mercier G, Fernandez H, de Tayrac R: Trans-vaginal cystocele repair using a tension-free polypropylene mesh: more than 5 years of follow-up. Eur J Obstet Gynecol Reprod Biol 2010;151:101–105.
5.
Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM: Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 2010;4:CD004014.
6.
Grody MHT: Urinary incontinence and concomitant prolapse. Clin Obstet Gynecol 1998;41:777–785.
7.
Chaikin DC, Groutz A, Blaivas JG: Predicting the need for anti-incontinence surgery in continent women undergoing repair of severe urogenital prolapse. J Urol 2000;163:531–534.
8.
Flynn MK, Amundsen C: Multidisciplinary management of female pelvic floor disorders; in Chapple CR, Zimmern PE, Brubaker L, Smith ARB, Bø K (eds): Multidisciplinary Management of Female Pelvic Floor Disorders. Churchill Livingstone, Philadelphia, 2006, pp 115–124.
9.
Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR: The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 1996;175:10–17.
10.
Blaivas JG, Groutz A: Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn 2000;19:553–564.
11.
Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA: Short forms to assess life quality and symptom distress for urinary incontinence in women. Neurourol Urodyn 1995;14:131–139.
12.
Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D’Agostino R Jr: The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191–208.
13.
de Leval J: Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur Urol 2003;44:724–730.
14.
Shah AD, Kohli N, Rajan SS, Hoyte L: The age distribution, rates, and types of surgery for pelvic organ prolapse in the U.S. Int Urogynecol J 2008;19:421–428.
15.
Nguyen JN, Burchette RJ: Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol 2008;111:891–898.
16.
Julian TM: The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol 1996;175:1472–1475.
17.
Swift SE, Tate SB, Nicholas J: Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol 2003;189:372–377.
18.
Herschorn S: Vaginal reconstructive surgery for sphincteric incontinence and prolapse; in Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (eds): Campbell-Walsh Urology. Philadelphia, Saunders, 2007, pp 2187–2232.
19.
FitzGerald MP, Kenton K, Shott S, Brubaker L: Responsiveness of quality of life measurements to change after reconstructive pelvic surgery. Am J Obstet Gynecol 2001;185:20–24.
20.
Hunskaar S, Burgio K, Clark A, Lapitan MC, Nelson R, Sillen U, Thom D: Epidemiology of urinary (UI) and faecal (FI) incontinence and pelvic organ prolapse; in Abrams P, Cardozo L, Khoury S, Wein A (eds): Incontinence. Plymouth, Health Publications, 2005, pp 255–312.
21.
Altman D, Väyrynen T, Engh ME, Axelsen S, Falconer C: Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med 2011;364:1826–1836.
22.
Okui N, Okui M, Horie S: Improvements in overactive bladder syndrome after polypropylene mesh surgery for cystocele. Aust NZ J Obstet Gynaecol 2009;49:226–231.
23.
Petros PE, Ulmsten UI: An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol Suppl 1993;153:1–93.
24.
Liedl B, Wagenlehner F, Petros P: Prolapse repair and stress urinary incontinence. Eur Urol Rev 2008;3:62–65.
25.
Cole EE, Kaufman MR, Scarpero HM, Dmochowski RR: The effects of isolated posterior compartment defects on lower urinary tract symptoms and urodynamic findings. BJU Int 2006;97:1024–1026.
26.
Meschia M, Pifarotti P, Spennacchio M, Buonaguidi A, Gattei U, Somigliana E: A randomized comparison of tension-free vaginal tape and endopelvic fascia plication in women with genital prolapse and occult stress urinary incontinence. Am J Obstet Gynecol 2004;190:609–613.
27.
Petros PE, Bush MB: A mathematical model of micturition gives new insights into pressure measurement and function. Int J Urogynecol 1998;9:103–107.
28.
Weber AM, Walters MD, Schover LR, Mitchinson A: Sexual function in women with uterovaginal prolapse and urinary incontinence. Obstet Gynecol 1995;85:483–487.
29.
Hoda MR, Wagner S, Greco F, Heynemann H, Fornara P: Prospective follow-up of female sexual function after vaginal surgery for pelvic organ prolapse using transobturator mesh implants. J Sex Med 2011;8:914–922.
30.
Caruso S, Bandiera S, Cavallaro A, Cianci S, Vitale SG, Rugolo S: Quality of life and sexual changes after double transobturator tension-free approach to treat severe cystocele. Eur J Obstet Gynecol Reprod Biol 2010;151:106–109.
31.
Altman D, Elmér C, Kiilholma P, Kinne I, Tegerstedt G, Falconer C, Nordic Transvaginal Mesh Group: Sexual dysfunction after trocar-guided transvaginal mesh repair of pelvic organ prolapse. Obstet Gynecol 2009;113:127–133.
32.
Choi KB, Jang SH, Lee MY, Kim KH: Sexual life and self-esteem in married elderly. Arch Gerontol Geriatr 2011;53:17–20.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.