Prolapse repair by vaginal route using a new protected low-weight polypropylene mesh: 1-year functional and anatomical outcome in a prospective multicentre study
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The aim of this study was to evaluate the anatomical and functional results of a low-weight polypropylene mesh coated with an absorbable film in prolapse surgery by vaginal route. We have conducted a prospective multicentre study in 13 gynaecological and urological units. There were 230 patients requiring repair for anterior or posterior vaginal prolapse included. The present report is based on the analysis of the first 143 patients evaluated after at least 10 months follow-up. All patients were operated by the vaginal route using a specially designed mesh (Ugytex, Sofradim, France). Prolapse severity were evaluated using the Pelvic Organ Prolapse staging system. Symptoms and quality of life were evaluated preoperatively and during follow-up using the validated Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) self-questionnaires. Mean age was 63 years (37–91). Anterior, posterior and anterior–posterior repair with the mesh were performed in 67 (46.9%), 11 (7.7%) and 65 (45.4%) patients, respectively. With a mean follow-up of 13 months (10–19), 132 patients were considered anatomically cured (92.3%) with a recurrence rate of 9 of 132 for cystocele (6.8%) and 2 of 76 for rectocele (2.6%). Nine vaginal erosions occurred (6.3%), six of them necessitated another procedure by simple excision. The rate of de novo dyspareunia was 12.8%. At follow-up, improvement of PFDI and PFIQ scores were highly significant (p<0.0001). The use of low-weight polypropylene mesh coated with a hydrophilic absorbable film for vaginal repair of genital prolapse seems to decrease local morbidity while maintaining low recurrence rates.
KeywordsGenital prolapse Vaginal surgery Low-weight polypropylene mesh Quality of life
We thank all the other investigators of the French Ugytex Study Group for their participation in the study: Jean-Louis Bénifla and Fabien Demaria (Rothschild Hospital, Paris), Jérome Blanchot and Pierre-Louis Broux (La Sagesse Private Hospital, Rennes), Michel Cosson and Jean-Philippe Lucot (Jeanne De Flandre University Hospital, Lille), Patrick Delporte (Public Hospital, Dunkerque), Hervé Fernandez (Antoine Béclere University Hospital, Clamart), Christine Frayret (Public Hospital, Chartres), François Hacquin (Santa Maria Private Hospital, Nice), Kazeem-Marc Maaliki (Franche Comté Private Hospital, Besançon) and Loïc Marpeau and Fabrice Sergent (University Hospital, Rouen).
- 10.Mage P (1999) Interposition of a synthetic mesh by vaginal approach in the cure of genital prolapse. J Gynecol Obstet Biol Reprod (Paris) 28(8):825–829Google Scholar
- 12.Hardiman P, Oyawoye S, Browning J (2000) Cystocele repair using polypropylene mesh. Br J Obstet Gynaecol 107:825–826Google Scholar
- 13.Sergent F, Marpeau L (2003) Prosthetic restoration of the pelvic diaphragm in genital urinary prolapse surgery trans-obturator and infracoccygeal hammock technique. J Gynecol Obstet Biol Reprod (Paris) 32(2):120–126Google Scholar
- 16.Dwyer PL, O’Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. Br J Obstet Gynaecol 111:831–836Google Scholar
- 17.Milani R, Salvatore S, Soligo M, Pifarotti P, Meschia M, Cortese M (2004) Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. Br J Obstet Gynaecol 111:1–5Google Scholar
- 18.de Tayrac R, Chauveaud-Lambling A, Fernandez D, Fernandez H (2003) Quality of life instruments for women with pelvic organ prolapse. J Gynecol Obstet Biol Reprod (Paris) 32:503–523Google Scholar
- 20.Amarenco G, Kerdraon J, Perrigot M (1992) [Echelle d’évaluation du handicap pelvien: mesure du handicap urinaire (MHU)] A urinary dysfunction measurement scale. In: Pelissier J, Coster P, Lopez S, Pares P (eds) Reeducation vésico-sphinctérienne et anorectale. Masson, Paris, pp 498–504Google Scholar