Title |
Native-tissue repair of isolated primary rectocele compared with nonabsorbable mesh: patient-reported outcomes
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Published in |
International Urogynecology Journal & Pelvic Floor Dysfunction, July 2016
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DOI | 10.1007/s00192-016-3072-y |
Pubmed ID | |
Authors |
Lene Duch Madsen, Emil Nüssler, Ulrik Schiøler Kesmodel, Susanne Greisen, Karl Møller Bek, Marianne Glavind-Kristensen |
Abstract |
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. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 17 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 5 | 29% |
Student > Ph. D. Student | 3 | 18% |
Student > Doctoral Student | 2 | 12% |
Student > Postgraduate | 2 | 12% |
Professor | 1 | 6% |
Other | 2 | 12% |
Unknown | 2 | 12% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 7 | 41% |
Nursing and Health Professions | 2 | 12% |
Psychology | 2 | 12% |
Social Sciences | 2 | 12% |
Agricultural and Biological Sciences | 1 | 6% |
Other | 1 | 6% |
Unknown | 2 | 12% |