Fascial Posterior Colpoperineorrhaphy

In Brief Objective: To determine the effect of fascial posterior colpoperineorrhaphy on bowel and sexual function. Methods: A retrospective observational study of women undergoing fascial colpoperineorrhaphy over a five-year period in a tertiary referral urogynecology unit. At follow up all women completed structured questionnaires and 34 (57%) of the women returned for clinical examination. Results: 80 women were identified who had undergone posterior colpoperineorrhaphy alone of whom 60 (75%) were available for analysis. Mean age was 55.8 years (range 32–86) and mean duration of follow up was 41 months (range 19–77). 34 women (57%) returned and were examined. Postoperatively prolapse symptoms due to rectocele decreased (88% versus 32%). Symptoms of vaginal pain (38% versus 17%), dyspareunia (33% versus 10%) vaginal laxity (25% versus 8%) and digitation to defecate (30% versus 10%) were all significantly reduced. However there was no significant difference in sexual activity (57% versus 45%), constipation (40% versus 37%), faecal incontinence (20% versus 17%) or troublesome lower urinary tract symptoms (52% versus 38%). Conclusion: Successful correction of posterior vaginal wall prolapse is possible using a fascial posterior colpoperineorrhaphy, leading to a significant improvement in symptoms of prolapse and dyspareunia without any deterioration in bowel or bladder function, suggesting that this technique may be superior to a standard conventional posterior vaginal wall repair. Successful correction of posterior vaginal wall prolapse is possible using a fascial posterior colpoperineorrhaphy, leading to a significant improvement in symptoms of prolapse and dyspareunia without any deterioration in bowel or bladder function.