Skip to main content

Advertisement

SpringerLink
Log in

Minimally invasive cystocele repair technique using a polypropylene mesh introduced with the transobturator route

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Evaluation of the safety and efficacy of the use of polypropylene mesh for cystocele repair using minimally invasive technique.

Methods

We retrospectively evaluated the perioperative events, short-term postoperative side-effects, and follow up for 152 patients who underwent repair for cystocele grade 2 or more using a polypropylene mesh. The repair was performed through a small anterior vaginal wall incision, with the arms of the mesh passed through a transobturator route using a corkscrew needle. Stress urinary incontinence (SUI) tests and the International Continence Society Pelvic Organ Prolapse Quantification (POP-Q) staging systems were documented before and after surgery.

Results

The average time and blood loss for the procedure were 18 min and 100 cc, respectively. Bladder injury and excess bleeding (>500 cc) occurred in one and two cases during the procedure, respectively. The early postoperative complications included pain (10.5 %), mesh erosion (1.3 %), fever (1.3 %), and urinary tract infection (7.9 %). Among the 122 patients who were followed up (median follow-up time, 18.2 months), the subjective and objective cure rates for the prolapse were 98 and 95 %, respectively. Complications during the follow up included mesh erosion (four cases) and persistent dyspareunia (four cases).

Conclusions

Cystocele repair with mesh placement through transobturator route can be considered a minimally invasive, promising method for the correction of cystocele and SUI based on the low rate of complications, the high rate of success, and the low incidence of recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME (2009) The prevalence of pelvic organ prolapse symptoms and signs and the their relation with bladder and bowel disorders in a general female population. Int Urogynecol J Pelvic Floor Dysfunct 20:1037–1045

    Article  PubMed Central  PubMed  Google Scholar 

  2. Comiter CV, Vasavada SP, Raz S (1999) Transvaginal culdosuspension: technique and results. Urology 54:819–822

    Article  CAS  PubMed  Google Scholar 

  3. Safir MH, Gousse AE, Rovner ES, Ginsberg DA, Raz S (1999) 4-Defect repair of grade 4 cystocele. J Urol 161:587–594

    Article  CAS  PubMed  Google Scholar 

  4. Moore RD, Miklos JR (2009) Vaginal repair of cystocele with anterior wall mesh via transobturator route: efficacy and complications with up to 3 years follow up. Adv Urol. doi:10.1155/2009/743831

    Google Scholar 

  5. Moore RD, Beyer RD, Jacoby K, Freedman SJ, McCammon KA, Gambla MT (2010) Prospective multicenter trial assessing type I, polypropylene mesh placed via transobturator route for the treatment of anterior vaginal prolapse with 2-year follow-up. Int Urogynecol J 21:545–552. doi:10.1007/s00192-009-1071-y

    Article  PubMed  Google Scholar 

  6. Withagen MI, Milani AL, den Boon J, Vervest MD, Vierhout ME (2011) Trocar-guided mesh compared with conventional vaginal repair in recurrent prolapse: a randomized trial. Obstet Gynecol 117:242–250. doi:10.1097/AOG.0b013e318203e6a5

    Article  PubMed  Google Scholar 

  7. Moore RD, Miklos JR (2009) Vaginal mesh kits for pelvic organ prolapse, friend or foe: a comprehensive review. Sci World J 9:163–189

    Article  Google Scholar 

  8. Sung VW, Rogers RG, Schaffer JI, Balk EM, Uhlig K, Lau J, Abed H, Wheeler TL 2nd, Morrill MY, Clemons JL, Rahn DD, Lukban JC, Lowenstein L, Kenton K, Young SB, Society of Gynecologic Surgeons Systematic Review Group (2008) Graft use in transvaginal pelvic organ prolapse repair: a systematic review. Obstet Gynecol 112:1131–1142. doi:10.1097/AOG.0b013e3181898ba9

    Article  PubMed  Google Scholar 

  9. Altman D, Falconer C (2007) Perioperative morbidity using transvaginal mesh in pelvic organ prolapse repair. Obstet Gynecol 109(2 Pt 1):303–308. doi:10.1097/01.AOG.0000250970.23128.63

    Article  PubMed  Google Scholar 

  10. Margulies RU, Lewicky-Gaupp C, DE Fenner, McGuire EJ, Clemens JQ, Delancy JO (2008) Complications requiring reoperation following vaginal mesh kit procedures for prolapse. Am J Obstet Gynecol 199:e1–e4. doi:10.1016/j.ajog.2008.07.049

    Article  PubMed  Google Scholar 

  11. Ridgeway B, Walters MD, Paraiso MF, Barber MD, McAchran SE, Goldman HB, Jelovsek JE (2008) Early experience with mesh excision for adverse outcomes after transvaginal mesh placement using prolapse kits. Am J Obstet Gynecol 199:e1–e7. doi:10.1016/j.ajog.2008.07.055

    Article  PubMed  Google Scholar 

  12. Iglesia CB, Sokol AL, Sokol ER, Kudish BI, Gutman RE, Peterson JL, Shott S (2010) Vaginal mesh for prolapse: a randomized controlled trial. Obstet Gynecol 116(2 Pt 1):293–303. doi:10.1097/AOG.0b013e3181e7d7f8

    Article  PubMed  Google Scholar 

  13. Persu C, Chapple CR, Cauni V, Gutue S, Geavlete P (2011) Pelvic organ prolapse quantification system (POP-Q)––a new era in pelvic prolapse staging. J Med Life 4:75–81

    CAS  PubMed Central  PubMed  Google Scholar 

  14. Jacquetin B, Fatton B, Rosenthal C, Clavé H, Debodinance P, Hinoul P, Gauld J, Garbin O, Berrocal J, Villet R, Salet Lizée D, Cosson M (2010) Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 3-year prospective follow-up study. Int Urogynecol J 21(12):1455–1462. doi:10.1007/s00192-010-1223-1230

    Article  PubMed  Google Scholar 

  15. Vaiyapuri GR, Han HC, Lee LC, Tseng AL, Wong HF (2012) Retrospective study of transobturator polypropylene mesh kit for the management of pelvic organ prolapse. Singap Med J 53(10):664–670

    Google Scholar 

  16. Renaudie J, Brouziyne M, Priou G, Devoldère Marie G, de Tayrac R (2013) Safety and 12 months results on stage 3–4, cystocele repair by the vaginal route using a light weight mesh. Prog Urol 23:237–243

    Article  CAS  PubMed  Google Scholar 

  17. Eboue C, Marcus-Braun N, von Theobald P (2010) Cystocele repair by transobturator four arms mesh; monocentric experience of 123 patients. Int Urogynecol J 21:85–93

    Article  PubMed  Google Scholar 

  18. Borrell Palanca A, Chicote Pérez F, Queipo Zaragoza JA, Beltran Meseguer JF, Esteve Claramunt J, Pastor Sempere F (2004) Cystocele repair with a polypropylene mesh: our experience. Arch Esp Urol 57:391–396

    PubMed  Google Scholar 

  19. Moore RD, Mitchell GK, Miklos JR (2012) Single-incision vaginal approach to treat cystocele and vault prolapse with an anterior wall mesh anchored apically to the sacrospinous ligaments. Int Urogynecol J 23:85–91

    Article  PubMed Central  PubMed  Google Scholar 

  20. Shek KL, Rane A, Goh J, Dietz HP (2009) Stress urinary incontinence after transobturator mesh for cystocele repair. Int Urogynecol J Pelvic Floor Dysfunct 20:421–425

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors have no acknowledgements to report.

Conflict of interest

The authors have no conflict of interest to declare.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Al Waili, Cairo Governorate, Cairo, 11762, Egypt

    Hazem Samour, Amgad Abougamra & Haitam A. M. Sabaa

Authors
  1. Hazem Samour
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amgad Abougamra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haitam A. M. Sabaa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Haitam A. M. Sabaa.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Samour, H., Abougamra, A. & Sabaa, H.A.M. Minimally invasive cystocele repair technique using a polypropylene mesh introduced with the transobturator route. Arch Gynecol Obstet 291, 79–84 (2015). https://doi.org/10.1007/s00404-014-3374-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-014-3374-6

Keywords

Search

Navigation