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[Three years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique].
Actas Urol Esp. 2010 Jan; 34(1):82-7.AU

Abstract

OBJECTIVES

To evaluate the long term efficacy and safety of transvaginal implantation of a non-resorbable synthetic prosthesis (Gynemesh) for the treatment of cystocele using transvaginal free tension technique.

MATERIALS AND METHODS

Prospective study of patients that have been submitted to correction of cystocele between April 2004 and July 2007. A prolene mesh was cut to an appropriate size to cover the whole cystocele leaving two tabs on each side. The two tabs of the mesh were then placed in paravaginal spaces, tension free, without stitches. Mesh was used in 31 patients. All patients had a symptomatic cystocele >or= 2 according to Baden-Walker halfway classification. Patients were reviewed initially at 1 and 3 month and then every 6 months.

RESULTS

The mean age of the patients was 58 years (range: 47-70 years). Mean parity was 5.8 (range 1-11), and mean weight was 75 kg (range 60-82Kg). All women were postmenopausal. The operation was combined with vaginal hysterectomy in 2 patients, Posterior colporraphy in 2 patients, Perineorrhaphy in 1 patient, Sacrospinous fixation in 2 patients, transobturator tape for stress urinary incontinence in 7 women. Average time of surgery was 23 minutes for cystocele. There were no major complications, such as trauma to the bladder, urethra, bowels, or large vessels in the patient group treated. There was no immediate postoperative complications (up to 7 days) recorded. No hematoma or infection was observed in the operative area. Mesh erosion was detected in one patient. It was treated by excision of the eroded part of the mesh. Mean follow-up was 36.4 months (18 to 52 months). Using our definition of success based on both anatomic and functional outcomes, the overall cure rate was 74.19% (asymptomatic with no or grade 1 cystocele). The improvement rate (asymptomatic with a grade 2 cystocele) was 19.35% and the overall failure rate (symptomatic or with a grade 3 or 4 cystocele) was only 6.4% (2 women).

DISCUSSION AND CONCLUSIONS

The interposition of a sub-vesical transversal tension-free polypropylene mesh by the vaginal route seems to be an excellent procedure in the definitive surgical treatment of anterior vaginal wall prolapse. This procedure is simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance. The results seem to be stable after three years of follow up.

Authors+Show Affiliations

Servicio de Urología, Hospital Militar Mohammed V, Rabat, Marruecos. ylg79@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
English Abstract
Journal Article

Language

spa

PubMed ID

20223137

Citation

El Harrech, Y, et al. "[Three Years Results of Transvaginal Cystocele Repair With Polypropylene Mesh Using a Tension-free Technique]." Actas Urologicas Espanolas, vol. 34, no. 1, 2010, pp. 82-7.
El Harrech Y, Ameur A, Janane A, et al. [Three years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique]. Actas Urol Esp. 2010;34(1):82-7.
El Harrech, Y., Ameur, A., Janane, A., Moufide, K., Ghadouane, M., & Abbar, M. (2010). [Three years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique]. Actas Urologicas Espanolas, 34(1), 82-7.
El Harrech Y, et al. [Three Years Results of Transvaginal Cystocele Repair With Polypropylene Mesh Using a Tension-free Technique]. Actas Urol Esp. 2010;34(1):82-7. PubMed PMID: 20223137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Three years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique]. AU - El Harrech,Y, AU - Ameur,A, AU - Janane,A, AU - Moufide,K, AU - Ghadouane,M, AU - Abbar,M, PY - 2010/3/13/entrez PY - 2010/3/13/pubmed PY - 2010/7/16/medline SP - 82 EP - 7 JF - Actas urologicas espanolas JO - Actas Urol Esp VL - 34 IS - 1 N2 - OBJECTIVES: To evaluate the long term efficacy and safety of transvaginal implantation of a non-resorbable synthetic prosthesis (Gynemesh) for the treatment of cystocele using transvaginal free tension technique. MATERIALS AND METHODS: Prospective study of patients that have been submitted to correction of cystocele between April 2004 and July 2007. A prolene mesh was cut to an appropriate size to cover the whole cystocele leaving two tabs on each side. The two tabs of the mesh were then placed in paravaginal spaces, tension free, without stitches. Mesh was used in 31 patients. All patients had a symptomatic cystocele >or= 2 according to Baden-Walker halfway classification. Patients were reviewed initially at 1 and 3 month and then every 6 months. RESULTS: The mean age of the patients was 58 years (range: 47-70 years). Mean parity was 5.8 (range 1-11), and mean weight was 75 kg (range 60-82Kg). All women were postmenopausal. The operation was combined with vaginal hysterectomy in 2 patients, Posterior colporraphy in 2 patients, Perineorrhaphy in 1 patient, Sacrospinous fixation in 2 patients, transobturator tape for stress urinary incontinence in 7 women. Average time of surgery was 23 minutes for cystocele. There were no major complications, such as trauma to the bladder, urethra, bowels, or large vessels in the patient group treated. There was no immediate postoperative complications (up to 7 days) recorded. No hematoma or infection was observed in the operative area. Mesh erosion was detected in one patient. It was treated by excision of the eroded part of the mesh. Mean follow-up was 36.4 months (18 to 52 months). Using our definition of success based on both anatomic and functional outcomes, the overall cure rate was 74.19% (asymptomatic with no or grade 1 cystocele). The improvement rate (asymptomatic with a grade 2 cystocele) was 19.35% and the overall failure rate (symptomatic or with a grade 3 or 4 cystocele) was only 6.4% (2 women). DISCUSSION AND CONCLUSIONS: The interposition of a sub-vesical transversal tension-free polypropylene mesh by the vaginal route seems to be an excellent procedure in the definitive surgical treatment of anterior vaginal wall prolapse. This procedure is simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance. The results seem to be stable after three years of follow up. SN - 1699-7980 UR - https://www.unboundmedicine.com/medline/citation/20223137/[Three_years_results_of_transvaginal_cystocele_repair_with_polypropylene_mesh_using_a_tension_free_technique]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/13147882 DB - PRIME DP - Unbound Medicine ER -