Long-term outcomes of laparoscopic repair of cystocoele

Background There is little information on the effectiveness of laparoscopic techniques for native tissue repair of cystocoele. Aim To assess the long-term outcome of laparoscopic cystocoele repair. Methods Two hundred and twenty-three women with symptomatic pelvic organ prolapse underwent laparoscopic paravaginal repair and treatment of associated conditions. Women were assessed pre-operatively and postoperatively at 6 weeks, 6 months, 12 months and then annually or biannually with pelvic organ prolapse quantification (POPQ) and subjective assessment at each visit. Results Median follow-up was 5.2 years (range: 1-12 years) with 140 women (63%) followed for at least 5 years. During follow-up, 79% of women developed prolapse of at least POPQ stage 2 in one or more compartments and 58% became symptomatic again. Overall, 48% underwent further prolapse surgery, but only 24% of women had an anterior prolapse beyond the hymen. Thirty per cent eventually had a further cystocoele repair. Conclusion Long-term follow-up of laparoscopic cystocoele repair shows that cystocoeles are difficult to repair successfully.