Simultaneous treatment of anterior vaginal wall prolapse and stress urinary incontinence by using transobturator four arms polypropylene mesh.
10.4111/kju.2015.56.12.811
- Author:
Farzaneh SHARIFIAGHDAS
1
;
Azar DANESHPAJOOH
;
Mahboubeh MIRZAEI
Author Information
1. Urology-Nephrology Research Center, Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Publication Type:Evaluation Studies ; Original Article
- Keywords:
Cystocele;
Dyspareunia;
Polypropylene;
Stress urinary incontinence
- MeSH:
Aged;
Aged, 80 and over;
Cystocele/complications/*surgery;
Female;
Follow-Up Studies;
Humans;
Middle Aged;
Polypropylenes;
Postoperative Complications;
Prospective Studies;
Quality of Life;
*Surgical Mesh;
Treatment Outcome;
Urinary Incontinence, Stress/complications/*surgery;
Urinary Tract Infections/etiology
- From:Korean Journal of Urology
2015;56(12):811-816
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the medium-term efficacy and safety of transobturator four-arm polypropylene mesh in the treatment of high-stage anterior vaginal wall prolapse and concomitant stress urinary incontinence (SUI). MATERIALS AND METHODS: Between September 2010 and August 2013, a prospective single-center trial was performed to evaluate women with stage> or =3 anterior vaginal wall prolapse with or without SUI who presented to Labbafinejad Hospital, Teheran, Iran, and underwent anterior vaginal wall repair with polypropylene mesh. Pre- and postoperative evaluation included history; physical examination using the Pelvic Organ Prolapse Quantification system and cough stress test, both before and after reduction of prolapsed structures; Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ); urinalysis and culture; and a postvoid residual assessment. Complications were reported at a mean of 2 years of follow-up. RESULTS: A total of 71 patients underwent cystocele repair with the transobturator four-arm polypropylene mesh. Seven of the patients were lost to follow-up. There were no perioperative complications. The anatomical success rate was 87.5%. The subjective success rate was 92.1%. The PFDI and PFIQ were significantly improved after surgery (p<0.001). Among those with the simultaneous complaint of SUI, 82% were cured without any additional procedure. Three patients (4.6%) experienced vaginal mesh extrusion. Two patients (3.1%) reported worsening of dyspareunia after surgery. CONCLUSIONS: The four arms polypropylene mesh is an effective device for simultaneous correction of anterior vaginal wall prolapse and SUI with a low complication rate at a medium-term follow-up. The majority of the subgroup with concomitant SUI were cured without a second simultaneous procedure.
