Cystocele Repair with Platelet-Rich Plasma

Abstract

Cystocele is the most common vaginal wall prolapse with high incidence of recurrence after operation. Our aim in this study was to show the effectiveness of using platelet-rich plasma with cystocele repair. Patients were assigned to 2 groups: (1) cystocele repair only and (2) cystocele repair with platelet-rich plasma injection. Each group consisted of 28 patients. There were no significant differences between the groups in terms of demographics features. They were re-assessed 4 weeks later, 6 months later and annually with the standard Pelvic Organ Prolapse Quantification system to detect anatomic recurrence, the Pelvic Floor Distress Inventory for assessment of symptomatic recurrence and Patient Impression of Global Improvement questionnaire for assessment of subjective success. At the end of the 48-month follow-up period, the results were compared between the groups. The main outcome was low recurrence rate with platelet-rich plasma administration and secondary outcome was lower Pelvic Floor Distress Inventory scale score and higher Patient Impression of Global Improvement questionnaire results. The decrease in prolapse symptoms ascertained with the Pelvic Floor Distress Inventory scale was more significant in group 2 (6 vs. 2, p = 0.002), reoperation rate for symptomatic cystocele recurrence was significantly lower in group 2 (5 (17.8%) vs. 1 (3.5%), p = 0.001) and also subjective success evaluated with Patient Impression of Global Improvement scale was significantly higher in group 2 (21 vs. 25, p = 0.012). Considering mesh complications, platelet-rich plasma administration may be a good alternative to prevent cystocele recurrence. However, further research is needed to evaluate the safety and efficacy of this treatment.