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Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles

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Abstract

This study assesses the use of Marlex mesh in conjunction with anterior colporrhaphy for the correction of cystocele with or without urinary stress incontinence. A retrospective review was carried out of 12 years' experience with 142 patients undergoing a modified anterior colporrhaphy reinforced with Marlex mesh. All patients had preoperative urodynamics. Pre- and post-operative symptoms were compared and patients were examined for recurrent prolapse and mesh complications. Mean follow-up time was 3.2 years. No patients experienced recurrent anterior vaginal wall prolapse. Three patients developed mesherosions into the vagina. There was a 74% success rate in the treatment of urinary stress incontinence. Marlex mesh used as a reinforcement for anterior colporrhaphy is effective in preventing recurrent anterior wall descent, with minimal complications.

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Authors and Affiliations

  1. Urogynecology and Urodynamic Investigative Unit, Mount Sinai Hospital and Department of Obstetrics and Gyneclogy, University of Toronto, Canada

    C. G. Flood,  H. P. Drutz (Professor and Head) & L. Waja

Authors
  1. C. G. Flood
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  2. H. P. Drutz
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  3. L. Waja
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Additional information

Editorial Comment: This is a retrospective review of a 12-year experience utilizing Marlex mesh placed and stabilized with interrupted sutures below the urethrovesical junction, combined with a traditional anterior colporrhaphy to treat symptomatic prolapse. The authors report a 100% success rate, in that no patient had recurrence of anterior wall prolapse greater than stage II. The procedure also was effective in treating concurrent genuine stress incontinence, with a respectable 74% success rate at 1 year postoperative urodynamic evaluation in a small subset of patients who received both pre- and postoperative testing. The erosion rate of the mesh into the vagina was 2%, compared to previously reported rates of 12.5%; 3.5% of patients experienced postoperative dyspareunia. Although these results in a large group of patients over an extended follow-up period appear promising, the description of the actual surgical procedure sounds more like a suburethral sling than a procedure that would give support to the entire length of the anterior vaginal wall. Studies by other centers are needed to confirm these findings.

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Flood, C.G., Drutz, H.P. & Waja, L. Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles. Int Urogynecol J 9, 200–204 (1998). https://doi.org/10.1007/BF01901604

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  • DOI: https://doi.org/10.1007/BF01901604

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