Cystocele and rectocele repair with native tissue layers: definition of the technique

Abstract

Objectives: To investigate the outcomes of central cystocele and rectocele repair using natural tissue layers.To describe a novel technique (Dogan technique). Material and methods: This is a retrospective cohort study. Between January 2021 and January 2023, patients who had central cystocele and rectocele higher than stage1 were included in the study.The Pelvic Organ Prolapse Quantification (POP-Q) score was used to determine the degree of the prolapsus. All cystocele and rectocele repair surgeries were performed by the same physician. The patients' voiding habits were assessed using ICIQ-SF and OAB-V8. Sexual function results were assessed with FSFI questionnaire before and after the operation.Transperineal ultrasonography was performed to examine mobility of the anterior and posterior compartments. Results: Total of 36 patients were diagnosed with grade 2 and above central cystocele (19, 52%) and rectocele (n = 17, 48%). After the operation the anatomical cure of anterior and posterior compartments was achieved for all patients in the two-years follow-up. According to voiding habits before the surgery, there were symptoms of stress urinary incontinence (SUI),urge urinary incontinence (URGE), both SUI and URGE, and no incontinence at the patients; 7 (36.8%), 14 (73.7%), 5 (26.3%), 3 (15.7%) respectively. Of those URGE patients (n = 5/14, 35.7%) incontinence symptoms were mixed-type. After the cystocele operation, significant improvement was seen in their voiding problems according to the ICIQ-SF and OAB-V8 questionnaires (p < 0.05). As well as significant improvement was found in sexual function according to the FSFI questionnaire (p < 0.05). Conclusions: We showed that strengthening the anterior and/or posterior compartments with native tissue improves urge and voiding dysfunctions via a novel technique (Dogan technique) without removing the vagina tissue.