Posterior Compartment Prolapse Occurrence After Anterior Vaginal Wall Suspension

Objective: To determine the long-term rate of posterior compartment prolapse (PCP) occurrence after native tissue repair of the anterior compartment with anterior vaginal wall suspension (AVWS) procedure. Methods: An institutional review board approved surgical prolapse database was reviewed for women who underwent AVWS for any degree of anterior compartment prolapse with minimum of 6-month follow-up and no history of apical or posterior compartment repair. Demographic data, smoking status, parity, and uterine status were collected. The primary outcome was need for secondary PCP repair. Results: A total of 300 women met inclusion criteria with a mean age of 63.8 ± 10.8 years, mean BMI of 26.1 ± 6.2 kg/m², and a mean parity of 2.5 ± 1.4. At the time of AVWS 46 women (15%) had uterine-sparing AVWS, 74 (25%) had concomitant hysterectomy, and 180 (60%) had prior hysterectomy. Forty-eight women (16%) had secondary posterior compartment repair for PCP (60% abdominal route, 40% done vaginally) over a mean follow-up of 7.1 ± 4.4 years. Conclusion: At long-term follow-up, less than 20% of women undergoing AVWS underwent PCP repair.