Reoperation rate and outcomes following the placement of polypropylene mesh by the vaginal route for cystocele: very long-term follow-up View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-08-11

AUTHORS

Marie Vinchant, Iris Bitumba, Vincent Letouzey, Hervé Fernandez, Renaud de Tayrac, Xavier Deffieux

ABSTRACT

Introduction and hypothesisThe aim was to evaluate the reoperation rate and outcomes in women who underwent transvaginal non-absorbable monofilament polypropylene mesh placement for the treatment of cystocele.MethodsThe retrospective cohort study included 63 patients who underwent transvaginal surgery using a synthetic polypropylene mesh (Gynemesh™) for cystocele. Patients were evaluated using a clinical examination (POP-Q) and validated questionnaires (PGI-I, PFDI-20, PFIQ-7) at 18 years of follow-up (median 18 years [IQR 16–19]). Cumulative death rate was 13 out of 63 (20%) and rate of total loss to follow-up was 21 out of 50 (42%). Finally, among the 63 women who underwent surgery, 29 completed maximum follow-up and 21 underwent a clinical examination.ResultsThe cumulative reoperation rate was 35% (22 out of 63). Three patients were reoperated on because of recurrence of pelvic organ prolapse. Among the 63 patients initially operated, vaginal mesh exposure occurred in 16 (25%) during follow-up and 11 women (17%) needed a reintervention for vaginal mesh exposure. One patient was reoperated on for bladder mesh exposure. Among the 29 women who completed follow-up, the overall postoperative improvement rate was 93% after 18 years (PGI-I: 1–3). Mean overall satisfaction rate was 80 out of 100. Functional success rate was 76% (22 out of 29) and anatomical success rate was 62% (13 out of 21). The median score of the POP-DI-6 was 4.1 (IQR: 0–11) and the median score of the PFDI-20 was 30.7 (IQR: 13–60) in the 29 women who completed maximum follow-up.ConclusionAt very long-term follow-up, the recurrence rate of cystocele following polypropylene mesh placement by the vaginal route remained low and the satisfaction rate was high. However, we found high cumulative reoperation and mesh exposure rates. More... »

PAGES

929-935

References to SciGraph publications

  • 2020-02-10. Joint report on terminology for surgical procedures to treat pelvic organ prolapse in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2013-08-14. Long-term outcomes of synthetic transobturator nonabsorbable anterior mesh versus anterior colporrhaphy in symptomatic, advanced pelvic organ prolapse surgery in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 1998-07. Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2017-09-11. Factors influencing the outcome of surgery for pelvic organ prolapse in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2007-11-07. Transvaginal cystocele repair with polypropylene mesh using a tension-free technique in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2013-04-06. Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 5-year prospective follow-up study in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2016-02-02. Long-term outcome after transvaginal mesh repair of pelvic organ prolapse in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2015-03-03. Transvaginal repair of stage III–IV cystocele using a lightweight mesh: safety and 36-month outcome in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2013-02-12. Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2017-11-22. Long-term outcome of vaginal mesh or native tissue in recurrent prolapse: a randomized controlled trial in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • 2020-01-07. Complications and reoperation after pelvic organ prolapse, impact of hysterectomy, surgical approach and surgeon experience in INTERNATIONAL UROGYNECOLOGY JOURNAL
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00192-020-04455-6

    DOI

    http://dx.doi.org/10.1007/s00192-020-04455-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1130028033

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32780172


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