As a result, modifiers can be used to allow billing for some procedures, such as colporrhaphy
, done at the same time as vaginal hysterectomy, or to bill for complex procedures that required substantial additional work.
In a 2010 Cochrane Database review, anterior colporrhaphy
was associated with more recurrent cystocele formation than standard repairs augmented with polyglactin mesh or porcine dermis inlay, polypropylene mesh as an overlay, or armed transobturator mesh.
MINNEAPOLIS, May 12, 2011 /PRNewswire/ -- American Medical Systems (AMS) a leading provider of world-class devices and therapies for male and female pelvic health, announced today the signing of a research grant contract for six sites to evaluate anatomical, functional and safety outcomes of two different treatments for vaginal prolapse, Anterior Colporrhaphy
, a technique which uses traditional suture plication, versus the Elevate Anterior and Apical Prolapse Repair System.
Anatomic success was achieved by 14 of 26 women (54%) in the colporrhaphy
group, 15 of 24 women (63%) in the porcine graft group, and 25 of 28 (89%) women in the synthetic mesh group.
Correcting concomitant SUI at the time of anterior vaginal surgery might offer a superior anatomical outcome compared with anterior colporrhaphy
The anatomical recurrence rate is lower with mesh (synthetic or biological) compared with anterior colporrhaphy
Despite the known potential high risk of failure, cystocele repair using the traditional anterior colporrhaphy
procedure developed by Kelly a century ago (Kelly plication) remains a popular method of repair.
3] Anterior colporrhaphy
has been the standard surgical treatment for anterior vaginal prolapse.
We have relied on these approaches despite recurrence rates of 40%-60% with traditional colporrhaphy
and up to 50% with paravaginal repairs.
For many years, the standard operative management of rectocele was a posterior colporrhaphy
, which usually included a fascial plication and sometimes a levator plication.
There are limited data comparing transvaginal mesh systems with traditional vaginal prolapse repairs or with traditional use of graft material in the form of augmented colporrhaphy
Current level 1 and 2 evidence indicates that the use of absorbable mesh as overlay to anterior colporrhaphy
offers a superior outcome compared with colporraphy alone.