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Prolapse repair by vaginal route using a new protected low-weight polypropylene mesh: 1-year functional and anatomical outcome in a prospective multicentre study

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Abstract

The aim of this study was to evaluate the anatomical and functional results of a low-weight polypropylene mesh coated with an absorbable film in prolapse surgery by vaginal route. We have conducted a prospective multicentre study in 13 gynaecological and urological units. There were 230 patients requiring repair for anterior or posterior vaginal prolapse included. The present report is based on the analysis of the first 143 patients evaluated after at least 10 months follow-up. All patients were operated by the vaginal route using a specially designed mesh (Ugytex, Sofradim, France). Prolapse severity were evaluated using the Pelvic Organ Prolapse staging system. Symptoms and quality of life were evaluated preoperatively and during follow-up using the validated Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) self-questionnaires. Mean age was 63 years (37–91). Anterior, posterior and anterior–posterior repair with the mesh were performed in 67 (46.9%), 11 (7.7%) and 65 (45.4%) patients, respectively. With a mean follow-up of 13 months (10–19), 132 patients were considered anatomically cured (92.3%) with a recurrence rate of 9 of 132 for cystocele (6.8%) and 2 of 76 for rectocele (2.6%). Nine vaginal erosions occurred (6.3%), six of them necessitated another procedure by simple excision. The rate of de novo dyspareunia was 12.8%. At follow-up, improvement of PFDI and PFIQ scores were highly significant (p<0.0001). The use of low-weight polypropylene mesh coated with a hydrophilic absorbable film for vaginal repair of genital prolapse seems to decrease local morbidity while maintaining low recurrence rates.

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References

  1. Benson J, Lucente V, McClellan E (1996) Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1422

    Article  PubMed  CAS  Google Scholar 

  2. Nygaard IE, McCreery R, Brubaker L, Connolly A, Cundiff G, Weber AM et al (2004) Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 104(4):805–823

    PubMed  Google Scholar 

  3. Miyazaki FS, Miyazaki DW (1994) Raz four-corner suspension for severe cystocele: poor results. Int Urogynecol J 5:94–97

    Article  Google Scholar 

  4. Kohli N, Sze EHM, Roat TW, Karram MM (1996) Incidence of recurrent cystocele after anterior colporrhaphy with or without concomitant transvaginal needle suspension. Am J Obstet Gynecol 175:1476–1482

    Article  PubMed  CAS  Google Scholar 

  5. Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomised trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1306

    Article  PubMed  CAS  Google Scholar 

  6. Sand PK, Koduri S, Lobel RW, Winkler HA, Tomezsko J, Culligan PJ et al (2001) Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol 184:1357–1364

    Article  PubMed  CAS  Google Scholar 

  7. Julian TM (1996) The efficacy or Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol 175:1472–1475

    Article  PubMed  CAS  Google Scholar 

  8. Nicita G (1998) A new operation for genitourinary prolapse. J Urol 160:741–745

    Article  PubMed  CAS  Google Scholar 

  9. Flood CG, Drutz HP, Waja L (1998) Anterior colporraphy reinforced with Marlex mesh for the treatment of cystoceles. Int Urogynecol J 9:200–204

    Article  CAS  Google Scholar 

  10. Mage P (1999) Interposition of a synthetic mesh by vaginal approach in the cure of genital prolapse. J Gynecol Obstet Biol Reprod (Paris) 28(8):825–829

    CAS  Google Scholar 

  11. Migliari R, De Angelis M, Madeddu G, Verdacchi T (2000) Tension-free vaginal mesh repair for anterior vaginal wall prolapse. Eur Urol 38:151–155

    Article  PubMed  CAS  Google Scholar 

  12. Hardiman P, Oyawoye S, Browning J (2000) Cystocele repair using polypropylene mesh. Br J Obstet Gynaecol 107:825–826

    Google Scholar 

  13. Sergent F, Marpeau L (2003) Prosthetic restoration of the pelvic diaphragm in genital urinary prolapse surgery trans-obturator and infracoccygeal hammock technique. J Gynecol Obstet Biol Reprod (Paris) 32(2):120–126

    CAS  Google Scholar 

  14. Adhoute F, Soyeur L, Pariente JL, Le Guillou M, Ferriere JM (2004) Use of transvaginal polypropylene mesh (Gynemesh) for the treatment of pelvic floor disorders in women. Prospective study in 52 patients. Prog Urol 14(2):192–196

    PubMed  Google Scholar 

  15. Shah DK, Paul EM, Rastinehad AR, Eisenberg ER, Baldani GH (2004) Short-term outcome analysis of total pelvis reconstruction with mesh: the vaginal approach. J Urol 171(1):261–263

    Article  PubMed  Google Scholar 

  16. Dwyer PL, O’Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. Br J Obstet Gynaecol 111:831–836

    Google Scholar 

  17. Milani R, Salvatore S, Soligo M, Pifarotti P, Meschia M, Cortese M (2004) Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. Br J Obstet Gynaecol 111:1–5

    Google Scholar 

  18. de Tayrac R, Chauveaud-Lambling A, Fernandez D, Fernandez H (2003) Quality of life instruments for women with pelvic organ prolapse. J Gynecol Obstet Biol Reprod (Paris) 32:503–523

    Google Scholar 

  19. Barber MD, Kuchibhatla MN, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395

    Article  PubMed  CAS  Google Scholar 

  20. Amarenco G, Kerdraon J, Perrigot M (1992) [Echelle d’évaluation du handicap pelvien: mesure du handicap urinaire (MHU)] A urinary dysfunction measurement scale. In: Pelissier J, Coster P, Lopez S, Pares P (eds) Reeducation vésico-sphinctérienne et anorectale. Masson, Paris, pp 498–504

    Google Scholar 

  21. de Tayrac R, Gervaise A, Chauveaud A, Fernandez H (2005) Tension-free polypropylene mesh for vaginal repair of anterior vaginal wall prolapse. J Reprod Med 50(2):75–80

    PubMed  Google Scholar 

  22. Eglin G, Ska JM, Serres X (2003) Trans-obturator subvesical mesh. Tolerance and short-term results of 103 case continuous series. Gynecol Obstet Fertil 31:14–19

    Article  PubMed  CAS  Google Scholar 

  23. de Tayrac R, Picone O, Chauveaud-Lambling A, Fernandez H (2006) Two-year anatomical and functional assessment of transvaginal rectocele repair using a polypropylene mesh. Int Urogynecol J Pelvic Floor Dysfunct 17(2):100–105

    Article  PubMed  Google Scholar 

  24. Petros PE (2001) Vault prolapse II: restoration of dynamic vaginal supports by infracoccygeal sacropexy, an axial day-case vaginal procedure. Int Urogynecol J Pelvic Floor Dysfunct 12:296–303

    Article  PubMed  CAS  Google Scholar 

  25. Arnaud JP, Hennekinne-Mucci S, Pessaux P, Tuech JJ, Aube C (2003) Ultrasound detection of visceral adhesion after intraperitoneal ventral hernia treatment: a comparative study of protected versus unprotected meshes. Hernia 7:85–88

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

We thank all the other investigators of the French Ugytex Study Group for their participation in the study: Jean-Louis Bénifla and Fabien Demaria (Rothschild Hospital, Paris), Jérome Blanchot and Pierre-Louis Broux (La Sagesse Private Hospital, Rennes), Michel Cosson and Jean-Philippe Lucot (Jeanne De Flandre University Hospital, Lille), Patrick Delporte (Public Hospital, Dunkerque), Hervé Fernandez (Antoine Béclere University Hospital, Clamart), Christine Frayret (Public Hospital, Chartres), François Hacquin (Santa Maria Private Hospital, Nice), Kazeem-Marc Maaliki (Franche Comté Private Hospital, Besançon) and Loïc Marpeau and Fabrice Sergent (University Hospital, Rouen).

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Correspondence to Renaud de Tayrac.

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de Tayrac, R., Devoldere, G., Renaudie, J. et al. Prolapse repair by vaginal route using a new protected low-weight polypropylene mesh: 1-year functional and anatomical outcome in a prospective multicentre study. Int Urogynecol J 18, 251–256 (2007). https://doi.org/10.1007/s00192-006-0135-5

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