Clinical importance and surgical outcomes of green type III cystocele in women with anterior vaginal prolapse

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives-To explore the clinical importance and surgical outcomes of Green type III cystocele in women with anterior vaginal prolapse. Methods-A database of 336 women with a Ba point higher than -3 cm on the Pelvic Organ Prolapse Quantification system was retrospectively reviewed. Investigated data comprised those obtained from a clinical interview, the Pelvic Organ Prolapse Quantification system, and sonography. Initially, the baseline data between women with (n = 126) and without (n = 210) Green type III cystocele on sonography were compared. Subsequently, 6-month postoperative data between women who had Green type III cystocele on sonography and underwent either anterior colporrhaphy (n = 25) or a Perigee procedure (n = 76) were compared. Results-Women with Green type III cystocele had symptoms of voiding dysfunction more frequently, stress urinary incontinence less frequently, and more bulging (mean ±SD, 2.7 ±1.2 versus 1.9 ±1.5 for women with versus without Green type III cystocele; P = .001), a greater likelihood of stage II or higher cystocele (86.5% versus 60.0% for women with versus without Green type III cystocele; P <.001), as well as more caudo -dorsal bladder neck and genitohiatal positions and a wider genital hiatus on sonography. Women with Green type III cystocele had a greater likelihood of stage 0 cystocele (64.0% versus 89.5% for anterior colporrhaphy versus Perigee; P<.001) and more ventral bladder neck positions after Perigee procedures. Conclusions-The presence of Green type III cystocele in women with anterior vaginal prolapse is associated with more functional impairments and anatomic defects. Despite comparable functional outcomes, Perigee procedures provide better anatomic outcomes for the anterior vagina in women with Green type III cystocele than anterior colporrhaphy does in the short term.

Original languageEnglish
Pages (from-to)2279-2285
Number of pages7
JournalJournal of Ultrasound in Medicine
Volume34
Issue number12
DOIs
Publication statusPublished - Dec 1 2015

Fingerprint

Cystocele
Uterine Prolapse
Ultrasonography
Pelvic Organ Prolapse
Urinary Bladder
Stress Urinary Incontinence
Vagina

Keywords

  • Anterior colporrhaphy
  • Anterior vaginal prolapse
  • Green type III cystocele
  • Gynecologic ultrasound
  • Transobturator vaginal mesh procedures

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

@article{9e577e2094f64ffaa612769e9a6fda3d,
title = "Clinical importance and surgical outcomes of green type III cystocele in women with anterior vaginal prolapse",
abstract = "Objectives-To explore the clinical importance and surgical outcomes of Green type III cystocele in women with anterior vaginal prolapse. Methods-A database of 336 women with a Ba point higher than -3 cm on the Pelvic Organ Prolapse Quantification system was retrospectively reviewed. Investigated data comprised those obtained from a clinical interview, the Pelvic Organ Prolapse Quantification system, and sonography. Initially, the baseline data between women with (n = 126) and without (n = 210) Green type III cystocele on sonography were compared. Subsequently, 6-month postoperative data between women who had Green type III cystocele on sonography and underwent either anterior colporrhaphy (n = 25) or a Perigee procedure (n = 76) were compared. Results-Women with Green type III cystocele had symptoms of voiding dysfunction more frequently, stress urinary incontinence less frequently, and more bulging (mean ±SD, 2.7 ±1.2 versus 1.9 ±1.5 for women with versus without Green type III cystocele; P = .001), a greater likelihood of stage II or higher cystocele (86.5{\%} versus 60.0{\%} for women with versus without Green type III cystocele; P <.001), as well as more caudo -dorsal bladder neck and genitohiatal positions and a wider genital hiatus on sonography. Women with Green type III cystocele had a greater likelihood of stage 0 cystocele (64.0{\%} versus 89.5{\%} for anterior colporrhaphy versus Perigee; P<.001) and more ventral bladder neck positions after Perigee procedures. Conclusions-The presence of Green type III cystocele in women with anterior vaginal prolapse is associated with more functional impairments and anatomic defects. Despite comparable functional outcomes, Perigee procedures provide better anatomic outcomes for the anterior vagina in women with Green type III cystocele than anterior colporrhaphy does in the short term.",
keywords = "Anterior colporrhaphy, Anterior vaginal prolapse, Green type III cystocele, Gynecologic ultrasound, Transobturator vaginal mesh procedures",
author = "Huang, {Wen Chen} and Yang, {Shwu Huey} and Yang, {Jenn Ming}",
year = "2015",
month = "12",
day = "1",
doi = "10.7863/ultra.14.11066",
language = "English",
volume = "34",
pages = "2279--2285",
journal = "Journal of Ultrasound in Medicine",
issn = "0278-4297",
publisher = "American Institute of Ultrasound in Medicine",
number = "12",

}

TY - JOUR

T1 - Clinical importance and surgical outcomes of green type III cystocele in women with anterior vaginal prolapse

AU - Huang, Wen Chen

AU - Yang, Shwu Huey

AU - Yang, Jenn Ming

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Objectives-To explore the clinical importance and surgical outcomes of Green type III cystocele in women with anterior vaginal prolapse. Methods-A database of 336 women with a Ba point higher than -3 cm on the Pelvic Organ Prolapse Quantification system was retrospectively reviewed. Investigated data comprised those obtained from a clinical interview, the Pelvic Organ Prolapse Quantification system, and sonography. Initially, the baseline data between women with (n = 126) and without (n = 210) Green type III cystocele on sonography were compared. Subsequently, 6-month postoperative data between women who had Green type III cystocele on sonography and underwent either anterior colporrhaphy (n = 25) or a Perigee procedure (n = 76) were compared. Results-Women with Green type III cystocele had symptoms of voiding dysfunction more frequently, stress urinary incontinence less frequently, and more bulging (mean ±SD, 2.7 ±1.2 versus 1.9 ±1.5 for women with versus without Green type III cystocele; P = .001), a greater likelihood of stage II or higher cystocele (86.5% versus 60.0% for women with versus without Green type III cystocele; P <.001), as well as more caudo -dorsal bladder neck and genitohiatal positions and a wider genital hiatus on sonography. Women with Green type III cystocele had a greater likelihood of stage 0 cystocele (64.0% versus 89.5% for anterior colporrhaphy versus Perigee; P<.001) and more ventral bladder neck positions after Perigee procedures. Conclusions-The presence of Green type III cystocele in women with anterior vaginal prolapse is associated with more functional impairments and anatomic defects. Despite comparable functional outcomes, Perigee procedures provide better anatomic outcomes for the anterior vagina in women with Green type III cystocele than anterior colporrhaphy does in the short term.

AB - Objectives-To explore the clinical importance and surgical outcomes of Green type III cystocele in women with anterior vaginal prolapse. Methods-A database of 336 women with a Ba point higher than -3 cm on the Pelvic Organ Prolapse Quantification system was retrospectively reviewed. Investigated data comprised those obtained from a clinical interview, the Pelvic Organ Prolapse Quantification system, and sonography. Initially, the baseline data between women with (n = 126) and without (n = 210) Green type III cystocele on sonography were compared. Subsequently, 6-month postoperative data between women who had Green type III cystocele on sonography and underwent either anterior colporrhaphy (n = 25) or a Perigee procedure (n = 76) were compared. Results-Women with Green type III cystocele had symptoms of voiding dysfunction more frequently, stress urinary incontinence less frequently, and more bulging (mean ±SD, 2.7 ±1.2 versus 1.9 ±1.5 for women with versus without Green type III cystocele; P = .001), a greater likelihood of stage II or higher cystocele (86.5% versus 60.0% for women with versus without Green type III cystocele; P <.001), as well as more caudo -dorsal bladder neck and genitohiatal positions and a wider genital hiatus on sonography. Women with Green type III cystocele had a greater likelihood of stage 0 cystocele (64.0% versus 89.5% for anterior colporrhaphy versus Perigee; P<.001) and more ventral bladder neck positions after Perigee procedures. Conclusions-The presence of Green type III cystocele in women with anterior vaginal prolapse is associated with more functional impairments and anatomic defects. Despite comparable functional outcomes, Perigee procedures provide better anatomic outcomes for the anterior vagina in women with Green type III cystocele than anterior colporrhaphy does in the short term.

KW - Anterior colporrhaphy

KW - Anterior vaginal prolapse

KW - Green type III cystocele

KW - Gynecologic ultrasound

KW - Transobturator vaginal mesh procedures

UR - http://www.scopus.com/inward/record.url?scp=84948754796&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948754796&partnerID=8YFLogxK

U2 - 10.7863/ultra.14.11066

DO - 10.7863/ultra.14.11066

M3 - Article

C2 - 26573101

AN - SCOPUS:84948754796

VL - 34

SP - 2279

EP - 2285

JO - Journal of Ultrasound in Medicine

JF - Journal of Ultrasound in Medicine

SN - 0278-4297

IS - 12

ER -