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Combined anterior trans-obturator mesh and sacrospinous ligament fixation in women with severe prolapse—a case series of 30 months follow-up

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Abstract

Introduction and hypothesis

To study the efficacy and safety of performing anterior mesh (Perigee) with vaginal reconstructive surgeries (sacrospinous ligament fixation) for treatment of advanced prolapse.

Methods

One hundred twenty-eight patients, POP-Q stage III (n = 85) or IV (n = 43), underwent surgery. The objective cure was defined as less than stage 2 prolapse. Introital ultrasonography was used for mesh morphological evaluation.

Results

Post-operative data were available for 120 patients. At 30 months, the objective cure was 91.8%. The subjective cure was 93.3% on POPDI-6 feedback. No apical and anterior recurrence was observed. Surgical complications were minor. Five cases (4.1%) of mesh extrusion was observed. Mesh shortening, shrinkage, and thickening was also observed.

Conclusion

The combination of anterior vaginal mesh and vaginal reconstructive surgery appears to be a safe and effective in restoring the anatomy and achieving favorable pelvic function. The anterior mesh deployed seems to cover a lesser area than anticipated. A longer period of follow-up is necessary to confirm its efficacy.

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Authors and Affiliations

  1. Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan

    Tsia-Shu Lo & Kiran Ashok

  2. Department of Obstetrics & Gynaecology, PES Institute of Medical Science & Research, Kuppam, Chittor Dist. A.P., India

    Kiran Ashok

  3. Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan Hsien, 333, Taiwan

    Tsia-Shu Lo

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  1. Tsia-Shu Lo
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Correspondence to Tsia-Shu Lo.

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Lo, TS., Ashok, K. Combined anterior trans-obturator mesh and sacrospinous ligament fixation in women with severe prolapse—a case series of 30 months follow-up. Int Urogynecol J 22, 299–306 (2011). https://doi.org/10.1007/s00192-010-1266-2

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  • DOI: https://doi.org/10.1007/s00192-010-1266-2

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