Transvaginal repair of stage III–IV cystocele using a lightweight mesh: safety and 36-month outcome View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-03-03

AUTHORS

Renaud de Tayrac, Majid Brouziyne, Gérard Priou, Guy Devoldère, Gérard Marie, Joël Renaudie

ABSTRACT

Introduction and hypothesisThe aim of this study was to assess the 36-month safety and efficacy of a lightweight polypropylene mesh used for the transvaginal repair of stage III–IV cystocele.MethodsA multicenter prospective cohort study was performed. Preoperative assessment included an interview and evaluation with the Pelvic Organ Prolapse Quantification (POP-Q) system. Inclusion criteria were stage III–IV cystocele and no contraindications for mesh use. A lightweight (28 g/m2) four-arm transobturator polypropylene mesh was used for the study. Pre- and postoperative symptoms and quality of life were assessed using the Urinary Symptoms Measurement (MHU), Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The main endpoint was mesh safety. Secondary endpoints were anatomic (Ba point ≤ −1) and functional success.ResultsIn all, 111 patients with a mean age of 67 ± 9 years (range 47–89) were included in the study, and 94 (84.7 %) were included in the analysis. Two intraoperative complications occurred (one bladder and one rectal injury, 2.2 %). Medium-term analysis of 79 patients (84 %) after 36 months showed a satisfaction rate of 98.7 % (78/79), a mesh contraction rate of 5.1 % (4/78), only one case of vaginal mesh exposure (1.3 %), no cases of chronic pelvic pain, and a postoperative dyspareunia rate of 2.8 % (1/36). The anatomic success rate of cystocele repair was 75/79 (94.9 %) and a highly significant improvement was noted for symptoms and on quality of life questionnaires. Overall, 7/79 patients (8.9 %) were reoperated, including 1 for hemorrhage, 1 for vaginal mesh exposure, 3 for stress urinary incontinence, and 2 for cystocele recurrence (2.5 %).ConclusionTransvaginal cystocele repair using a lightweight transobturator polypropylene mesh was safe and efficient in the medium term. Long-term data and comparative studies are needed. More... »

PAGES

1147-1154

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00192-015-2659-z

DOI

http://dx.doi.org/10.1007/s00192-015-2659-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1007356827

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25731722


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34 schema:description Introduction and hypothesisThe aim of this study was to assess the 36-month safety and efficacy of a lightweight polypropylene mesh used for the transvaginal repair of stage III–IV cystocele.MethodsA multicenter prospective cohort study was performed. Preoperative assessment included an interview and evaluation with the Pelvic Organ Prolapse Quantification (POP-Q) system. Inclusion criteria were stage III–IV cystocele and no contraindications for mesh use. A lightweight (28 g/m2) four-arm transobturator polypropylene mesh was used for the study. Pre- and postoperative symptoms and quality of life were assessed using the Urinary Symptoms Measurement (MHU), Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The main endpoint was mesh safety. Secondary endpoints were anatomic (Ba point ≤ −1) and functional success.ResultsIn all, 111 patients with a mean age of 67 ± 9 years (range 47–89) were included in the study, and 94 (84.7 %) were included in the analysis. Two intraoperative complications occurred (one bladder and one rectal injury, 2.2 %). Medium-term analysis of 79 patients (84 %) after 36 months showed a satisfaction rate of 98.7 % (78/79), a mesh contraction rate of 5.1 % (4/78), only one case of vaginal mesh exposure (1.3 %), no cases of chronic pelvic pain, and a postoperative dyspareunia rate of 2.8 % (1/36). The anatomic success rate of cystocele repair was 75/79 (94.9 %) and a highly significant improvement was noted for symptoms and on quality of life questionnaires. Overall, 7/79 patients (8.9 %) were reoperated, including 1 for hemorrhage, 1 for vaginal mesh exposure, 3 for stress urinary incontinence, and 2 for cystocele recurrence (2.5 %).ConclusionTransvaginal cystocele repair using a lightweight transobturator polypropylene mesh was safe and efficient in the medium term. Long-term data and comparative studies are needed.
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