Skip to main content
Top
Published in: International Urogynecology Journal 10/2007

01-10-2007 | Original Article

Anterior compartment prolapse repair with a hybrid biosynthetic mesh implant technique

Authors: Jose E. Robles, Jorge Rioja, Abel Saiz, Xavier Brugarolas, David Rosell, J. Javier Zudaire, Jose M. Berian

Published in: International Urogynecology Journal | Issue 10/2007

Login to get access

Abstract

The aim of the present study is to assess the safety and feasibility of a new technique for cystocele repair using a hybrid biosynthetic graft fixed by the transobturator approach. This is a retrospective study of 13 women diagnosed with symptomatic anterior compartment prolapse that were in stages II and IV, using Pelvic Organ Prolapse Quantification score and treated between 2003 and 2006. The surgical procedure was carried out through a vaginal approach, exposing the arcus tendineus and the posterior surface of the obturator foramen from the ischial spine to the inferior pubic ramus bone. The patients were followed-up after 3, 6 and 12 months. The anatomical cure rate was 85% (stage 0), although two patients had a recurrence 8 months after surgery. All patients would repeat the procedure, if necessary. No de novo dyspareunia was observed in these small series. The results suggest that this technique is safe and feasible and is a comprehensive surgical approach for anterior compartment prolapse, without postoperative morbidity.
Literature
1.
go back to reference Weber AM, Richter HE (2005) Pelvic organ prolapse. Obstet Gynecol 106:615–634PubMed Weber AM, Richter HE (2005) Pelvic organ prolapse. Obstet Gynecol 106:615–634PubMed
2.
go back to reference Hogston P (2002) Urogenital prolapse. In: Pemberton J, Swash M, Henry M (eds) The pelvic floor. Its function and disorders. Saunders, London, pp 251–264 Hogston P (2002) Urogenital prolapse. In: Pemberton J, Swash M, Henry M (eds) The pelvic floor. Its function and disorders. Saunders, London, pp 251–264
3.
go back to reference Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporraphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1306PubMedCrossRef Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporraphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1306PubMedCrossRef
4.
go back to reference Walters MD, Paraiso MFR (2005) Anterior vaginal wall prolapse: innovative surgical approaches. Clevel Clin J Med 72(Suppl 4):S20–S27 Walters MD, Paraiso MFR (2005) Anterior vaginal wall prolapse: innovative surgical approaches. Clevel Clin J Med 72(Suppl 4):S20–S27
5.
go back to reference Baessler K, Maher CH (2006) Mesh augmentation during pelvic-floor reconstructive surgery: risk and benefits. Curr Opin Obstet Gynecol 18:560–566PubMedCrossRef Baessler K, Maher CH (2006) Mesh augmentation during pelvic-floor reconstructive surgery: risk and benefits. Curr Opin Obstet Gynecol 18:560–566PubMedCrossRef
6.
go back to reference Walshe CJ, Wall L (2002) Anterior compartment. In: Stanton S, Zimmern P (eds) Female pelvic reconstructive surgery. Springer, Berlin Heidelberg New York pp 161–178 Walshe CJ, Wall L (2002) Anterior compartment. In: Stanton S, Zimmern P (eds) Female pelvic reconstructive surgery. Springer, Berlin Heidelberg New York pp 161–178
7.
go back to reference Brubaker L, Bump R, Jacquetin B, Schuessler B, Weidner A, Zimmern P, Milani R (2002) Pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence 2nd (edn). Plymbridge, Plymouth, UK, pp 243–265 Brubaker L, Bump R, Jacquetin B, Schuessler B, Weidner A, Zimmern P, Milani R (2002) Pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence 2nd (edn). Plymbridge, Plymouth, UK, pp 243–265
8.
go back to reference Shull BL, Bachofen C, Coates KW, Kuehl TJ (2000) A transvaginal approach to repair of apical and other associated sites of pelvic organ prolapse with uterosacral ligaments. Am J Obstet Gynecol 183:1365–1374PubMedCrossRef Shull BL, Bachofen C, Coates KW, Kuehl TJ (2000) A transvaginal approach to repair of apical and other associated sites of pelvic organ prolapse with uterosacral ligaments. Am J Obstet Gynecol 183:1365–1374PubMedCrossRef
9.
go back to reference Slack M (2004) Management of the prolapse of the anterior compartment. BJOG 111(Suppl 1):67–72PubMed Slack M (2004) Management of the prolapse of the anterior compartment. BJOG 111(Suppl 1):67–72PubMed
10.
go back to reference Viana R, Colaco J, Vieira A, Goncalves V, Retto H (2006) Cystocele-vaginal approach to repairing paravaginal fascial defects. Int Urogynecol J Pelvic Floor Dysfunct 17:621–623PubMedCrossRef Viana R, Colaco J, Vieira A, Goncalves V, Retto H (2006) Cystocele-vaginal approach to repairing paravaginal fascial defects. Int Urogynecol J Pelvic Floor Dysfunct 17:621–623PubMedCrossRef
11.
go back to reference Huebner M, Hsu Y, Fenner DE (2006) The use of graft materials in vaginal pelvic floor surgery. Int J Gynecol Obstet Suppl 92:279–288CrossRef Huebner M, Hsu Y, Fenner DE (2006) The use of graft materials in vaginal pelvic floor surgery. Int J Gynecol Obstet Suppl 92:279–288CrossRef
12.
go back to reference Collinet P, Bellot F, Debodiance P, Ha Duc E, Lucot HP, Cosson M (2006) Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors. Int Urogynecol J Pelvic Floor Dysfunct 17:315–320PubMedCrossRef Collinet P, Bellot F, Debodiance P, Ha Duc E, Lucot HP, Cosson M (2006) Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors. Int Urogynecol J Pelvic Floor Dysfunct 17:315–320PubMedCrossRef
13.
go back to reference Milani R, Salvatore S, Soligo M, Pifarotti P, Meschia M, Cortese M (2005) Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. BJOG 112:107–111PubMedCrossRef Milani R, Salvatore S, Soligo M, Pifarotti P, Meschia M, Cortese M (2005) Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. BJOG 112:107–111PubMedCrossRef
14.
go back to reference Doumerc N, Mouly P, Thanwerdas J, Vazzoler N, Khedis M, Huyghe E, Soulie M, Palnte P (2006) Efficacy and safety of Pelvicol in the vaginal treatment of prolapse. Prog Urol 16:58–61PubMed Doumerc N, Mouly P, Thanwerdas J, Vazzoler N, Khedis M, Huyghe E, Soulie M, Palnte P (2006) Efficacy and safety of Pelvicol in the vaginal treatment of prolapse. Prog Urol 16:58–61PubMed
15.
go back to reference Salomon LJ et al (2004) Treatment of anterior vaginal wall prolapse with porcine skin collagen implant by the transobturator route: preliminary results. Eur Urol 45:219–225PubMedCrossRef Salomon LJ et al (2004) Treatment of anterior vaginal wall prolapse with porcine skin collagen implant by the transobturator route: preliminary results. Eur Urol 45:219–225PubMedCrossRef
16.
go back to reference Sullivan ES, Longaker CJ, Lee PY (2001) Total pelvic mesh repair: a ten-year experience. Dis Colon Rectum 44:857–863PubMedCrossRef Sullivan ES, Longaker CJ, Lee PY (2001) Total pelvic mesh repair: a ten-year experience. Dis Colon Rectum 44:857–863PubMedCrossRef
17.
go back to reference Cosson M, Caquant F, Collinet P, Rosenthal C, Clave H, Debodinance P, Garbin O, Berrocal J, Villet R, Jacquetin B (2005) Prolift (mesh (Gynecare) for pelvic organ prolapse surgical treatment using the TVM group technique: a retrospective study of 687 patients. Neurourol Urodyn 24:590–591 Cosson M, Caquant F, Collinet P, Rosenthal C, Clave H, Debodinance P, Garbin O, Berrocal J, Villet R, Jacquetin B (2005) Prolift (mesh (Gynecare) for pelvic organ prolapse surgical treatment using the TVM group technique: a retrospective study of 687 patients. Neurourol Urodyn 24:590–591
18.
go back to reference De Tayrac R, Devoldere G, Reanudie J, Villard P, Guilbaud G, Eglin G, The French Ugytex Study Group (2006) Prolapse repair by vaginal route using a new protected low-weight polypropylene mesh: 1-year functional and anatomical outcome in a prospective multicentre trial. Int Urogynecol J Pelvic Floor Dysfunct (in press). DOI 10.1007/s00192-006-0135-5 De Tayrac R, Devoldere G, Reanudie J, Villard P, Guilbaud G, Eglin G, The French Ugytex Study Group (2006) Prolapse repair by vaginal route using a new protected low-weight polypropylene mesh: 1-year functional and anatomical outcome in a prospective multicentre trial. Int Urogynecol J Pelvic Floor Dysfunct (in press). DOI 10.​1007/​s00192-006-0135-5
19.
go back to reference Maher C, Baessler K, Glazener CMA, Adams EJ, Hagen S (2004) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev Issue 4. Art. No.: CD004014. DOI 10.1002/14651858. CD004014.pub2 Maher C, Baessler K, Glazener CMA, Adams EJ, Hagen S (2004) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev Issue 4. Art. No.: CD004014. DOI 10.​1002/​14651858. CD004014.pub2
20.
go back to reference Birch C (2005) The use of prosthetics in pelvic reconstructive surgery. Best Pract Res Clin Obstet Gynaecol 9:979–991CrossRef Birch C (2005) The use of prosthetics in pelvic reconstructive surgery. Best Pract Res Clin Obstet Gynaecol 9:979–991CrossRef
21.
go back to reference Maher C, Baessler K (2006) Surgical management of anterior vaginal wall prolapse: an evidencebased literatura review. Int Urogynecol J Pelvic Floor Dysfunct 17:195–201PubMedCrossRef Maher C, Baessler K (2006) Surgical management of anterior vaginal wall prolapse: an evidencebased literatura review. Int Urogynecol J Pelvic Floor Dysfunct 17:195–201PubMedCrossRef
22.
go back to reference Brubaker L, Bump R, Fynes M, Jacquetin B, Karram M, Kreder K, Maher C, Norton P (2005) Surgery for pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence Vol 2. Health Publication Ltd, Paris, pp 1371–1402 Brubaker L, Bump R, Fynes M, Jacquetin B, Karram M, Kreder K, Maher C, Norton P (2005) Surgery for pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence Vol 2. Health Publication Ltd, Paris, pp 1371–1402
23.
go back to reference Deprest J, Zheng F, Konstantinovic M, Spelzini F, Claerhout F, Steensma A, Ozog Y, De Ridder D (2006) The biology behind fascial defects and the use of implants in pelvic organ prolapse repair. Int Urogynecol J Pelvic Floor Dysfunct 17:S16–S25PubMedCrossRef Deprest J, Zheng F, Konstantinovic M, Spelzini F, Claerhout F, Steensma A, Ozog Y, De Ridder D (2006) The biology behind fascial defects and the use of implants in pelvic organ prolapse repair. Int Urogynecol J Pelvic Floor Dysfunct 17:S16–S25PubMedCrossRef
24.
go back to reference Davila GW, Drutz H, Deprest J (2006) Clinical implications of the biology of grafts: conclusions of the 2005 IUGA Grafts Roundtable. Int Urogynecol J Pelvic Floor Dysfunct 17:S51–S55PubMedCrossRef Davila GW, Drutz H, Deprest J (2006) Clinical implications of the biology of grafts: conclusions of the 2005 IUGA Grafts Roundtable. Int Urogynecol J Pelvic Floor Dysfunct 17:S51–S55PubMedCrossRef
25.
go back to reference Zheng F, Lin Y, Verbeken E, Claerhout F, Fastrez M, De Ridder D, Deprest J (2004) Host response after reconstruction of abdominal wall defects with porcine dermal collagen in a rat model. Am J Obstet Gynecol 191:1961–1970PubMedCrossRef Zheng F, Lin Y, Verbeken E, Claerhout F, Fastrez M, De Ridder D, Deprest J (2004) Host response after reconstruction of abdominal wall defects with porcine dermal collagen in a rat model. Am J Obstet Gynecol 191:1961–1970PubMedCrossRef
26.
go back to reference Ruparelia B, Gunasheela S, Sundar K (2000) Anterior and Posterior vaginal prolapse repairs with porcine skin collagen (PelvicolTM) implant. Int Urogynecol J Pelvic Floor Dysfunct 11(Suppl 1):FDP33–S45 Ruparelia B, Gunasheela S, Sundar K (2000) Anterior and Posterior vaginal prolapse repairs with porcine skin collagen (PelvicolTM) implant. Int Urogynecol J Pelvic Floor Dysfunct 11(Suppl 1):FDP33–S45
27.
go back to reference Abdel-Fattah M, Barrington JW, Arunkalaivanan AS (2004) Pelvicol pubovaginal sling versus tension-free vaginal tape for treatment of urodynamic stress incontinence: a prospective randomized three-year follow-up study. Eur Urol 46:629–635PubMed Abdel-Fattah M, Barrington JW, Arunkalaivanan AS (2004) Pelvicol pubovaginal sling versus tension-free vaginal tape for treatment of urodynamic stress incontinence: a prospective randomized three-year follow-up study. Eur Urol 46:629–635PubMed
28.
go back to reference Leboeuf L, Miles R, Kim S, Gousse A (2004) Grade 4 cystocele repair using four-defect repair and porcine xenograft acellular matrix (Pelvicol): outcome measures using SEAPI. Urology 64:282–286PubMedCrossRef Leboeuf L, Miles R, Kim S, Gousse A (2004) Grade 4 cystocele repair using four-defect repair and porcine xenograft acellular matrix (Pelvicol): outcome measures using SEAPI. Urology 64:282–286PubMedCrossRef
29.
go back to reference Livesey SA, Herndon DN, Hollyoak MA, Atkinson YH, Nag A (1995) Transplanted acellular allograft dermal matrix. Potential as a template for the reconstruction of viable dermis. Transplantation 60:1–9PubMedCrossRef Livesey SA, Herndon DN, Hollyoak MA, Atkinson YH, Nag A (1995) Transplanted acellular allograft dermal matrix. Potential as a template for the reconstruction of viable dermis. Transplantation 60:1–9PubMedCrossRef
30.
go back to reference Wheeler T II, Richter H, Duke A, Burgio KL, Redden D, Varner R (2006) Outcomes with porcine graft placement in the anterior vaginal compartment in patients who undergo high vaginal uterosacral suspension and cystocele repair. Am J Obstet Gynecol 194:1486–1491PubMedCrossRef Wheeler T II, Richter H, Duke A, Burgio KL, Redden D, Varner R (2006) Outcomes with porcine graft placement in the anterior vaginal compartment in patients who undergo high vaginal uterosacral suspension and cystocele repair. Am J Obstet Gynecol 194:1486–1491PubMedCrossRef
31.
go back to reference Gomelsky A, Rudy DC, Dmochoswski RR (2004) Porcine dermis interposition graft for repair of high grade anterior compartment defects with or without concomitant pelvic organ prolapse procedures. J Urol 171:1581–1584PubMedCrossRef Gomelsky A, Rudy DC, Dmochoswski RR (2004) Porcine dermis interposition graft for repair of high grade anterior compartment defects with or without concomitant pelvic organ prolapse procedures. J Urol 171:1581–1584PubMedCrossRef
32.
go back to reference Miaadi N, Ferhi K, Descargue G, Grise P (2005) Transvaginal treatment of anterior vaginal prolapse with collagen implant transobturator fixation. Prog Urol 15:1110–1113PubMed Miaadi N, Ferhi K, Descargue G, Grise P (2005) Transvaginal treatment of anterior vaginal prolapse with collagen implant transobturator fixation. Prog Urol 15:1110–1113PubMed
33.
go back to reference David-Montefiore E, Barranguer E, Dubernard G, Detchev R, Nizard V, Darai E (2005) Treatment of genital prolapse by hammock using porcine skin collagen implant (Pelvicol). Urology 66:1314–1318PubMedCrossRef David-Montefiore E, Barranguer E, Dubernard G, Detchev R, Nizard V, Darai E (2005) Treatment of genital prolapse by hammock using porcine skin collagen implant (Pelvicol). Urology 66:1314–1318PubMedCrossRef
34.
go back to reference Rodriguez L, Bukkapatnam R, Shah S, Raz S (2005) Transvaginal paravaginal repair of high-grade cystocele central and lateral defects with concomitant suburethral sling: report of early results, outcomes, and patient satisfaction with a new technique. Urology 66:57–65PubMedCrossRef Rodriguez L, Bukkapatnam R, Shah S, Raz S (2005) Transvaginal paravaginal repair of high-grade cystocele central and lateral defects with concomitant suburethral sling: report of early results, outcomes, and patient satisfaction with a new technique. Urology 66:57–65PubMedCrossRef
35.
go back to reference Mallipeddi PK, Steele AC, Kohli N, Karram MM (2001) Anatomic and functional outcome of vaginal paravaginal repair in the correction of anterior vaginal wall prolapse. Int Urogynecol J Pelvic Floor Dysfunct 12:83–88PubMedCrossRef Mallipeddi PK, Steele AC, Kohli N, Karram MM (2001) Anatomic and functional outcome of vaginal paravaginal repair in the correction of anterior vaginal wall prolapse. Int Urogynecol J Pelvic Floor Dysfunct 12:83–88PubMedCrossRef
36.
go back to reference Tunuguntla HSGR, Gousse AE (2006) Female sexual dysfunction following vaginal surgery: a review. J Urol 175:439–446PubMedCrossRef Tunuguntla HSGR, Gousse AE (2006) Female sexual dysfunction following vaginal surgery: a review. J Urol 175:439–446PubMedCrossRef
37.
go back to reference Walters MD (2003) The use and misuse of prosthetic materials in reconstructive pelvic surgery: does the evidence support our surgical practice?. Int Urogynecol J Pelvic Floor Dysfunct 14:365–366PubMedCrossRef Walters MD (2003) The use and misuse of prosthetic materials in reconstructive pelvic surgery: does the evidence support our surgical practice?. Int Urogynecol J Pelvic Floor Dysfunct 14:365–366PubMedCrossRef
Metadata
Title
Anterior compartment prolapse repair with a hybrid biosynthetic mesh implant technique
Authors
Jose E. Robles
Jorge Rioja
Abel Saiz
Xavier Brugarolas
David Rosell
J. Javier Zudaire
Jose M. Berian
Publication date
01-10-2007
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 10/2007
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-006-0298-0

Other articles of this Issue 10/2007

International Urogynecology Journal 10/2007 Go to the issue