Management of anterior vaginal prolapse in South Africa – results of a national survey

Abstract

Objective: A national survey of the management of anterior vaginal prolapse among gynecologists and urologists in South Africa.

Methods: 822 Questionnaires were sent by post to all registered gynecologists and urologists in South Africa.

Results: 47 Questionnaires were returned undelivered, and 234 (30.2%) were returned completed. This comprised 180 gynecologists (23.2%) and 54 urologists (7.0%). The POP-Q staging system was used most commonly (37.6%), but 36.3% did not use any recognized system. Urodynamic investigation was done preoperatively by 8.6% of the gynecologists and 20.8% of the urologists (p= 0.0121; 95% confidence interval (CI) = -24.0%; -0.7%). Anterior colporraphy was done by 85.5% of the respondents, vaginal paravaginal repair by 41.9%, and mesh was used by 55.1%. Urologists more often made use of mesh (p= 0.001; 95%CI = -43.3%; -16.9%).

Conclusion: The practice of anterior vaginal prolapse was fairly standard except for a low report of preoperative urodynamics by gynecologists and a high use of synthetic mesh by urologists.