Combined abdominal sacrocolpopexy and Burch colposuspension for the treatment of stage 3 and 4 anterior compartment prolapse

Abstract

Objective. To review our experience with sacrocolpopexy and Burch colposuspension for stage 3 and 4 anterior compartment prolapse. Methods. Review of 154 patient records drawn from a urogynaecological database, with stage 3 and 4 anterior compartment prolapse treated by sacrocolpopexy and Burch colposuspension. Results. The median age of the patients was 60 years and a third of them had had previous prolapse surgery. Patients presented with bladder (41%) and bowel (55%) symptoms, and most complained of prolapse protruding through the vaginal introitus (86%). Recurrent prolapse, stage 2 - 4, occurred in 24 patients (15.6%); 9.7% were anterior compartment prolapses. Where mesh was omitted from the anterior vaginal wall but placed on the posterior vaginal wall, significantly more recurrent anterior compartment prolapses occurred (95% confidence interval (CI) 0.2%; 34.8%) compared with cases where mesh was placed both anteriorly and posteriorly to the vagina. Perioperative complications occurred in 13% of patients. A tension-free vaginal tape (TVT) procedure for urinary stress incontinence was done at a later stage in 8% of the patients. Conclusion. Sacrocolpopexy effectively treated anterior compartment prolapse where mesh was attached to the anterior vaginal wall as well. A Burch colposuspension probably did not make a difference. South African Journal of Obstetrics and Gynaecology Vol. 13 (3) 2007: pp. 84-90