Skip to main content

Advertisement

Log in

A prospective, randomized, controlled study comparing Gynemesh®, a synthetic mesh, and Pelvicol®, a biologic graft, in the surgical treatment of recurrent cystocele

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

We compared safety and efficacy of Gynemesh PS® and Pelvicol® for recurrent cystocele repair. One hundred ninety patients were randomly divided into Gynemesh PS® and Pelvicol® groups and underwent tension-free cystocele repair. The Chi-square test was used to compare categorical variables, the paired t test for continuous parametric variables, and the Mann–Whitney test for continuous nonparametric variables. Ninety-six Gynemesh PS® patients and 94 Pelvicol® patients were studied. Mesh erosions occurred in 6.3% of Gynemesh PS® patients. No erosions were observed in Pelvicol® patients (p = 0.02). Objective cure was 71.9% for Gynemesh PS® and 56.4% for Pelvicol® (p = 0.06). Subjective cure was the same in both groups except for better sexuality in the Pelvicol® group. At 24 months follow-up, only Gynemesh PS® patients had mesh erosions. Anatomical outcome was similar in the two groups. Pelvicol® gave a better impact on voiding and sexuality.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

LM:

levator myorrhaphy

POP:

pelvic organ prolapse

POP-Q:

pelvic organ prolapse quantification

PISQ-12:

Pelvic Organ Prolapse–Urinary Incontinence Sexual Questionnaire

TCR:

tension-free cystocele repair

References

  1. Boyles SH, Weber AM, Meyn L (2003) Procedures for pelvic organ prolapse in the United States, 1979–1997. Am J Obstet Gynecol 188:108–115

    Article  PubMed  Google Scholar 

  2. Olsen AL, Smith VJ, Bergstrom JO, Collinq JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 87:501–506

    Article  Google Scholar 

  3. Birch C, Fynes MM (2002) The role of synthetic and biologic prostheses in reconstructive pelvic floor surgery. Curr Opin Obstet Gynecol 14:527–535

    Article  PubMed  Google Scholar 

  4. Norton P, Boyd C, Deak S (1992) Collagen synthesis in women with genital prolapse or stress urinary incontinence. Neurol Urodyn 11:300–301

    Google Scholar 

  5. Rechberger T, Postawsi K, Jakowicki JA (1998) Role of fascial collagen in stress urinary incontinence. Am J Obstet Gynecol 179(6Pt1):1511–1514

    Article  PubMed  CAS  Google Scholar 

  6. Wong MJ, Harmanli OH, Agar M (2003) Collagen content of nonsupportive tissue in pelvic organ prolapse and stress urinary incontinence. Am J Obstet Gynecol 189:1597–1599

    Article  PubMed  CAS  Google Scholar 

  7. Boreham MK, Miller RT, Schaffer JI, Word RA (2001) Smooth muscle myosin heavy chain and caldesmon exp in the anterior vaginal wall of women with and without organ prolapse. Am J Obstet Gynecol 185:944–952

    Article  PubMed  CAS  Google Scholar 

  8. Amid PK (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1:15–21

    Article  Google Scholar 

  9. Ridgeway B, Chen CCG, Paraiso MFR (2008) The use of synthetic mesh in pelvic reconstructive surgery. Clin Obstet Gynecol 51:136–152

    Article  PubMed  Google Scholar 

  10. Le TH, Kon L, Bathia NN, Ostergard DR (2007) Update on the utilization of grafts in pelvic reconstruction surgeries. Curr Opin Obstet Gynecol 19:480–489

    PubMed  Google Scholar 

  11. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Karskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  PubMed  CAS  Google Scholar 

  12. Digesu GA, Santamato S, Kullar V, Santillo V, Digesu A, Cormio G et al (2003) Validation of an Italian version of prolapse quality of life questionnaire. Eur J Obstet Gynecol Reprod Biol 106:184–192

    Article  PubMed  Google Scholar 

  13. Roger RG, Coates KW, Kammerer-Doak D, Khalsa S, Qualls C (2003) A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual questionnaire (PISQ-12). Int Urogynecol J 14:164–168

    Article  Google Scholar 

  14. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2002) The standardisation of terminology of lower urinary tract function: report from the standardization sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178

    Article  PubMed  Google Scholar 

  15. Cervigni M, Natale F, La Penna C, Panei M, Mako (2008) A transvaginal cystocele repair with polypropylene mesh using a tension-free technique. Int Urogynecol J Pelvic Floor Dysfunct 19:489–496

    Article  PubMed  CAS  Google Scholar 

  16. Hiltunene R, Nieminen K, Tarala T, Heiskanen E, Merikari M, Niemi K et al (2007) Low-weight polypropylene mesh for anterior vaginal wall prolapse: a randomized controlled trial. Obstet Gynecol 110:455–462

    Google Scholar 

  17. Nguyen JN, Burchette RJ (2008) Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol 111:891–898

    PubMed  Google Scholar 

  18. Julian TM (1996) The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol 175:1472–1475

    Article  PubMed  CAS  Google Scholar 

  19. Flood CG, Drutz HP, Waja L (1998) Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles. Int Urogynecol J Pelvic Floor Dysfunct 9:200–204

    Article  PubMed  CAS  Google Scholar 

  20. de Tayrac R, Gervaise A, Chauveaud A, Fernandez H (2005) Tension-free polypropylene mesh for vaginal repair of anterior vaginal wall prolapse. J Reprod Med 50:75–80

    PubMed  Google Scholar 

  21. De Tayrac R, Deffieux X, Gervaise A, Chauveaud-Lambing A, Fernandez H (2006) Long-term anatomical and functional assessment of the trans-vaginal cystocele repair using a tension-free polypropylene mesh. Int Urogynecol J Pelvic Floor Dysfunct 18:251–256

    PubMed  Google Scholar 

  22. Debodinance P, Berrocal J, Clavè H, Cosson M, Garbin O, Jacquetin B et al (2004) Changing attitudes on the surgical treatment of urogenital prolapse: birth of the tension-free vaginal mesh. J Gynecol Obstet Biol Reprod 33:577–588

    CAS  Google Scholar 

  23. Deffieux X, de Tayrac R, Huel C, Bottero J, Gervaise A (2007) Vaginal mesh erosion after trans-vaginal repair of cystocele using Gynemesh or Gynemesh-Soft in 138 women: a comparative study. Int Urogynecol J 18:73–79

    Article  CAS  Google Scholar 

  24. Jakus SM, Shapiro A, Hall CD (2008) Biologic and synthetic graft use in pelvic surgery: a review. Obstet Gynecol Survey 63:253–266

    Article  Google Scholar 

  25. David-Montefiore E, Barranger E, Dubernard G, Detchev R, Nizard V, Darai E (2005) Treatment of genital prolapse by hammock using porcine skin collagen implant (Pelvicol). Urology 66:1314–1318

    Article  PubMed  Google Scholar 

  26. Meschia M, Pifarotti P, Bernasconi F, Magatti F, Riva D, Kocjancic E (2007) Porcine skin collagen implants to prevent anterior vaginal wall prolapse recurrence: a multicenter, randomized study. J Urol 177:192–195

    Article  PubMed  Google Scholar 

  27. Handel LN, Frenkl TL, Kim JH (2007) Results of cystocele repair: a comparison of traditional anterior colporrhaphy polypropylene mesh and porcine dermis. J Urol 178:153–156

    Article  PubMed  Google Scholar 

  28. Gauruder-Burmester A, Koutouzidou P, Rohne J, Gronewold M, Tunn R (2007) Follow-up after polypropylene mesh repair of anterior and posterior compartments in patients with recurrent prolapse. Int Urogynecol J 18:1059–1064

    Article  CAS  Google Scholar 

  29. Davila GW, Drutz D, Deprest J (2006) Clinical implications of the biology of the grafts: conclusions of the 2005 IUGA Grafts Roundtable. Int Urogynecol J 17:S51–S55

    Article  Google Scholar 

  30. Lemack GE, Zimmern PE, Blander DS (2000) The levator myorrhaphy repair for vaginal vault prolapse. Urology 56:50–54

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to F. Natale.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Natale, F., La Penna, C., Padoa, A. et al. A prospective, randomized, controlled study comparing Gynemesh®, a synthetic mesh, and Pelvicol®, a biologic graft, in the surgical treatment of recurrent cystocele. Int Urogynecol J 20, 75–81 (2009). https://doi.org/10.1007/s00192-008-0732-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-008-0732-6

Keywords

Navigation