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Utero-vaginal suspension using bilateral vaginal anterior sacrospinous fixation with mesh: intermediate results of a cohort study

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Abstract

Introduction and hypothesis

Pelvic organ prolapse is a major burden for the public health system, affecting up to 30 % of all women. One mesh kit has been introduced for pelvic organ prolapse surgery that can be inserted via a single anterior incision with the mesh arms driven through the sacrospinous ligament in a tension-free manner. The aim of this study was to describe the medium-term results of this vaginal mesh kit procedure for the combined treatment of the anterior vaginal wall and vault prolapse.

Methods

This is a longitudinal case series of patients undergoing an anterior mesh operation between 2009 and 2013. All patients presenting with symptomatic stage II prolapse or higher were included when a minimum follow-up of 12 months was achieved. A structured interview and clinical examination were performed pre- and postoperatively.

Results

One hundred and eighteen consecutive patients were operated with the Uphold® system during the study period. Three patients did not complete the 12-month follow-up and were excluded from the analysis, leaving 115 patients. Anatomical success at a mean follow-up of 23 months was 93 %, with a patient satisfaction rate of 95 %. Four patients (8 %) experienced de novo dyspareunia related to the mesh. The reoperation rate for mesh-related complications was 3.4 %; no patients were re-operated for POP recurrence.

Conclusions

The subjective and objective cure rates were high and the mesh-related re-operation rate was 3 % in the medium term, suggesting that this surgical technique may be an option for women requiring anterior and apical prolapse repair.

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Conflicts of interest

VL, DU, EB and AC declare that they have no conflicts of interest.

R. de Tayrac: Consultant for Boston Scientific, Partnership for research with Aspide Medical and Coloplast.

B. Fatton: Consultant for Boston scientific, Astellas and Allergan.

Authors’ contributions

Vincent Letouzey and Daniela Ulrich contributed equally to this work.

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Author notes

  1. Daniela Ulrich

    Present address: Department of Obstetrics and Gynecology, Medical University Graz, Graz, Austria

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, CHU Caremeau, Place du Professeur-Robert-Debré, 30029, Nîmes, France

    Vincent Letouzey, Daniela Ulrich, Eva Balenbois, Arnaud Cornille, Renaud de Tayrac & Brigitte Fatton

Authors
  1. Vincent Letouzey
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  2. Daniela Ulrich
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  3. Eva Balenbois
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  5. Renaud de Tayrac
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  6. Brigitte Fatton
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Correspondence to Daniela Ulrich.

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Letouzey, V., Ulrich, D., Balenbois, E. et al. Utero-vaginal suspension using bilateral vaginal anterior sacrospinous fixation with mesh: intermediate results of a cohort study. Int Urogynecol J 26, 1803–1807 (2015). https://doi.org/10.1007/s00192-015-2748-z

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  • DOI: https://doi.org/10.1007/s00192-015-2748-z

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