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Infracoccygeal sacropexy reinforced with posterior mesh interposition for apical and posterior compartment prolapse.
Eur J Obstet Gynecol Reprod Biol. 2008 Mar; 137(1):108-13.EJ

Abstract

OBJECTIVE

To assess the efficacy, safety and functional outcome of infracoccygeal sacropexy reinforced with posterior mesh interposition performed alone or in combination with the implantation of other prosthetic materials for prolapse repair.

STUDY DESIGN

Seventy-two patients requiring prolapse repair for apical and/or posterior compartment prolapse, operated between March 2002 and September 2005. Patients underwent physical examination for prolapse assessment according to the international pelvic organ prolapse staging system and were evaluated for objective and subjective prolapse symptoms pre- and post-operatively. Objective success was defined by the midline posterior vaginal wall at stage 0 or 1, while subjective success was defined by a score above or equal to 7.5 measured on a visual analogue scale (0, very disappointed; 10, very satisfied). Follow-up was done at 6 weeks, 6 months and then once a year.

RESULTS

Seventy-two patients with a mean age of 65 years were followed-up with a median of 26.3 months (range 10-43). Stages 3 and 4 represented 65.3% of all apical and/or posterior compartment prolapse. Fifty-nine patients had a concomitant anterior prolapse repair. Both objective and subjective success rates were 97.2%. All subjective prolapse symptoms decreased after surgery. The only intraoperative complication was one rectal injury. Vaginal erosion rate was 13.9% and mesh infection rate was 4.2%. Vaginal erosions statistically occurred less often with monofilament polypropylene (5.7%, 2/35) than with multifilament polypropylene (13.6%, 3/22) or polyester (33.3%, 5/15) (p<.04).

CONCLUSION

Infracoccygeal sacropexy reinforced with posterior mesh interposition provides effective and promising results in correcting apical and/or posterior compartment prolapse. Analysis of long-term success rates and comparison with previously accepted surgical procedures are required to determine the place of this procedure in the strategy of genital prolapse repair.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Rouen University Hospital, Charles Nicolle, Rouen, France. Loic.Sentilhes@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18206290

Citation

Sentilhes, Loïc, et al. "Infracoccygeal Sacropexy Reinforced With Posterior Mesh Interposition for Apical and Posterior Compartment Prolapse." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 137, no. 1, 2008, pp. 108-13.
Sentilhes L, Sergent F, Resch B, et al. Infracoccygeal sacropexy reinforced with posterior mesh interposition for apical and posterior compartment prolapse. Eur J Obstet Gynecol Reprod Biol. 2008;137(1):108-13.
Sentilhes, L., Sergent, F., Resch, B., Verspyck, E., Descamps, P., & Marpeau, L. (2008). Infracoccygeal sacropexy reinforced with posterior mesh interposition for apical and posterior compartment prolapse. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 137(1), 108-13. https://doi.org/10.1016/j.ejogrb.2007.10.011
Sentilhes L, et al. Infracoccygeal Sacropexy Reinforced With Posterior Mesh Interposition for Apical and Posterior Compartment Prolapse. Eur J Obstet Gynecol Reprod Biol. 2008;137(1):108-13. PubMed PMID: 18206290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Infracoccygeal sacropexy reinforced with posterior mesh interposition for apical and posterior compartment prolapse. AU - Sentilhes,Loïc, AU - Sergent,Fabrice, AU - Resch,Benoît, AU - Verspyck,Eric, AU - Descamps,Philippe, AU - Marpeau,Loïc, PY - 2007/03/16/received PY - 2007/09/05/revised PY - 2007/10/31/accepted PY - 2008/1/22/pubmed PY - 2008/6/18/medline PY - 2008/1/22/entrez SP - 108 EP - 13 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 137 IS - 1 N2 - OBJECTIVE: To assess the efficacy, safety and functional outcome of infracoccygeal sacropexy reinforced with posterior mesh interposition performed alone or in combination with the implantation of other prosthetic materials for prolapse repair. STUDY DESIGN: Seventy-two patients requiring prolapse repair for apical and/or posterior compartment prolapse, operated between March 2002 and September 2005. Patients underwent physical examination for prolapse assessment according to the international pelvic organ prolapse staging system and were evaluated for objective and subjective prolapse symptoms pre- and post-operatively. Objective success was defined by the midline posterior vaginal wall at stage 0 or 1, while subjective success was defined by a score above or equal to 7.5 measured on a visual analogue scale (0, very disappointed; 10, very satisfied). Follow-up was done at 6 weeks, 6 months and then once a year. RESULTS: Seventy-two patients with a mean age of 65 years were followed-up with a median of 26.3 months (range 10-43). Stages 3 and 4 represented 65.3% of all apical and/or posterior compartment prolapse. Fifty-nine patients had a concomitant anterior prolapse repair. Both objective and subjective success rates were 97.2%. All subjective prolapse symptoms decreased after surgery. The only intraoperative complication was one rectal injury. Vaginal erosion rate was 13.9% and mesh infection rate was 4.2%. Vaginal erosions statistically occurred less often with monofilament polypropylene (5.7%, 2/35) than with multifilament polypropylene (13.6%, 3/22) or polyester (33.3%, 5/15) (p<.04). CONCLUSION: Infracoccygeal sacropexy reinforced with posterior mesh interposition provides effective and promising results in correcting apical and/or posterior compartment prolapse. Analysis of long-term success rates and comparison with previously accepted surgical procedures are required to determine the place of this procedure in the strategy of genital prolapse repair. SN - 0301-2115 UR - https://www.unboundmedicine.com/medline/citation/18206290/Infracoccygeal_sacropexy_reinforced_with_posterior_mesh_interposition_for_apical_and_posterior_compartment_prolapse_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(07)00465-4 DB - PRIME DP - Unbound Medicine ER -