Francesco Deltetto1, Alessandro Favilli2, Giovanni Buzzaccarini3, Amerigo Vitagliano4. 1. San Luca Nursing Home, Torino, Italy. 2. Department of Obstetrics and Gynecology, AOUI Verona, Verona, Italy. 3. Gynecological Division, San Camillo Hospital, Trento, Italy. 4. Department of Women and Children's Health, Unit of Gynecology and Obstetrics, University of Padua, 35128 Padua, Italy.
Abstract
OBJECTIVE: The use of transvaginal mesh is controversial, and over time, multiple surgical methods for the treatment of posterior vaginal prolapse (PVP) have been proposed including different surgical approaches and techniques. To date, no clear conclusion has been reached about the use of mesh for reinforcing transvaginal posterior repair. The aim of this study was to evaluate the feasibility, safety, and effectiveness of a novel, ultralightweight mesh for the treatment of PVP. METHODS: We performed a single-center, prospective observational study on consecutive patients referred for primary or recurrent, symptomatic stage II PVP (according to the international Pelvic Organ Prolapse Quantification System) from April 2017 to September 2018. In all patients, transvaginal posterior repair was augmented with a single-incision, isoelastic polypropylene mesh. Data about the postoperative outcomes were collected until December 2019. RESULTS: A total number of 15 patients were included. The median follow-up after surgery was 18 months (IQR = 14). Surgery was completed in all cases without complications. Regarding the anatomical outcomes (as measured according to POP-q classification), a significant improvement was observed in terms of Bp, D, and C (p < 0.05). The functional outcomes were significantly ameliorated after surgery, with a reduction of bulge symptom, stypsis, incomplete evacuation, and excessive staining (p < 0.05). The quality of life was significantly improved in the majority of patients (p < 0.05). Median patients' satisfaction rate was 100% (IQR = 22.5%). Neither early nor late postoperative complications occurred. CONCLUSIONS: Single-incision, ultralightweight polypropylene meshes were safe and highly effective in the treatment of PVP. As our study has some limitations, further large, controlled studies are needed.
OBJECTIVE: The use of transvaginal mesh is controversial, and over time, multiple surgical methods for the treatment of posterior vaginal prolapse (PVP) have been proposed including different surgical approaches and techniques. To date, no clear conclusion has been reached about the use of mesh for reinforcing transvaginal posterior repair. The aim of this study was to evaluate the feasibility, safety, and effectiveness of a novel, ultralightweight mesh for the treatment of PVP. METHODS: We performed a single-center, prospective observational study on consecutive patients referred for primary or recurrent, symptomatic stage II PVP (according to the international Pelvic Organ Prolapse Quantification System) from April 2017 to September 2018. In all patients, transvaginal posterior repair was augmented with a single-incision, isoelastic polypropylene mesh. Data about the postoperative outcomes were collected until December 2019. RESULTS: A total number of 15 patients were included. The median follow-up after surgery was 18 months (IQR = 14). Surgery was completed in all cases without complications. Regarding the anatomical outcomes (as measured according to POP-q classification), a significant improvement was observed in terms of Bp, D, and C (p < 0.05). The functional outcomes were significantly ameliorated after surgery, with a reduction of bulge symptom, stypsis, incomplete evacuation, and excessive staining (p < 0.05). The quality of life was significantly improved in the majority of patients (p < 0.05). Median patients' satisfaction rate was 100% (IQR = 22.5%). Neither early nor late postoperative complications occurred. CONCLUSIONS: Single-incision, ultralightweight polypropylene meshes were safe and highly effective in the treatment of PVP. As our study has some limitations, further large, controlled studies are needed.
Authors: Philippe Ferry; Pauline Bertherat; Anne Gauthier; Richard Villet; Francesco Del Piano; David Hamid; Hervé Fernandez; Pierre-Louis Broux; Delphine Salet-Lizée; Etienne Vincens; Pierre Ntshaykolo; Philippe Debodinance; Philippe Pocholle; Yannick Thirouard; Renaud de Tayrac Journal: J Gynecol Obstet Hum Reprod Date: 2018-06-18
Authors: Cathryn Ma Glazener; Suzanne Breeman; Andrew Elders; Christine Hemming; Kevin G Cooper; Robert M Freeman; Anthony Rb Smith; Fiona Reid; Suzanne Hagen; Isobel Montgomery; Mary Kilonzo; Dwayne Boyers; Alison McDonald; Gladys McPherson; Graeme MacLennan; John Norrie Journal: Lancet Date: 2016-12-21 Impact factor: 79.321