International Urogynecology Journal

, Volume 24, Issue 2, pp 249–254

Clinical efficacy of a trocar-guided mesh kit for repairing lateral defects

Authors

    • Division of Obstetrics and Gynaecology, Department of Clinical Science and EducationSödersjukhuset, Karolinska Institutet
    • Department of Obstetrics and GynecologySödersjukhuset
  • Daniel Altman
    • Division of Obstetrics and Gynecology, Department of Clinical ScienceDanderyd Hospital, Karolinska Institutet
    • Department of Medical Epidemiology and BiostatisticsKarolinska Institutet
  • Jonas Gunnarsson
    • Department of Obstetrics and GynecologySahlgrenska University Hospital
  • Christian Falconer
    • Division of Obstetrics and Gynecology, Department of Clinical ScienceDanderyd Hospital, Karolinska Institutet
  • Gunilla Tegerstedt
    • Unit of Obstetrics and Gynecology, CLINTECKarolinska University Hospital at Huddinge, Karolinska Institutet
Original Article

DOI: 10.1007/s00192-012-1833-9

Cite this article as:
Ek, M., Altman, D., Gunnarsson, J. et al. Int Urogynecol J (2013) 24: 249. doi:10.1007/s00192-012-1833-9

Abstract

Introduction and hypothesis

The optimal surgery for lateral defects is not well defined. Our objective was to assess the effects of anterior trocar-guided transvaginal mesh repair versus anterior colporrhaphy in women with lateral defects.

Methods

This subanalysis from a randomized controlled trial of mesh kit versus anterior colporrhaphy assessed 99 patient diagnosed at baseline with lateral defects in the anterior vaginal wall. Thirty-nine patients underwent anterior colporrhaphy and 60 anterior trocar-guided transvaginal mesh surgery.

Results

One year after surgery, a persistent lateral defect was significantly more common after colporrhaphy compared with transvaginal mesh [11/32 (34.4 %) vs 1/42 (2.4 %), risk ratio (RR) 14.4, 95 % confidence interval (CI) 2.0–106.1; P < 0.001)] However, there were no significant differences between treatment groups with regard to subjective symptoms as reflected by the overall Urogenital Distress Inventory scores, with mean difference from baseline 37.3 ± 50.6 in the colporrhaphy group vs 39.0 ± 45.8 in the mesh group (p = 0.61).

Conclusions

Use of a transvaginal mesh kit increases the odds for anatomical correction of lateral defects compared with anterior colporrhaphy but does not necessarily improve lower urinary tract symptoms.

Keywords

Anterior vaginal prolapsecolporrhaphyLateral defectMesh

Copyright information

© The International Urogynecological Association 2012