Skip to main content
Top
Published in: International Urogynecology Journal 3/2007

01-03-2007 | Original Article

Prolapse repair by vaginal route using a new protected low-weight polypropylene mesh: 1-year functional and anatomical outcome in a prospective multicentre study

Authors: Renaud de Tayrac, Guy Devoldere, Joël Renaudie, Pierre Villard, Olivier Guilbaud, Georges Eglin, The French Ugytex Study Group

Published in: International Urogynecology Journal | Issue 3/2007

Login to get access

Abstract

The aim of this study was to evaluate the anatomical and functional results of a low-weight polypropylene mesh coated with an absorbable film in prolapse surgery by vaginal route. We have conducted a prospective multicentre study in 13 gynaecological and urological units. There were 230 patients requiring repair for anterior or posterior vaginal prolapse included. The present report is based on the analysis of the first 143 patients evaluated after at least 10 months follow-up. All patients were operated by the vaginal route using a specially designed mesh (Ugytex, Sofradim, France). Prolapse severity were evaluated using the Pelvic Organ Prolapse staging system. Symptoms and quality of life were evaluated preoperatively and during follow-up using the validated Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) self-questionnaires. Mean age was 63 years (37–91). Anterior, posterior and anterior–posterior repair with the mesh were performed in 67 (46.9%), 11 (7.7%) and 65 (45.4%) patients, respectively. With a mean follow-up of 13 months (10–19), 132 patients were considered anatomically cured (92.3%) with a recurrence rate of 9 of 132 for cystocele (6.8%) and 2 of 76 for rectocele (2.6%). Nine vaginal erosions occurred (6.3%), six of them necessitated another procedure by simple excision. The rate of de novo dyspareunia was 12.8%. At follow-up, improvement of PFDI and PFIQ scores were highly significant (p<0.0001). The use of low-weight polypropylene mesh coated with a hydrophilic absorbable film for vaginal repair of genital prolapse seems to decrease local morbidity while maintaining low recurrence rates.
Literature
1.
go back to reference Benson J, Lucente V, McClellan E (1996) Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1422PubMedCrossRef Benson J, Lucente V, McClellan E (1996) Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: a prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 175:1418–1422PubMedCrossRef
2.
go back to reference Nygaard IE, McCreery R, Brubaker L, Connolly A, Cundiff G, Weber AM et al (2004) Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 104(4):805–823PubMed Nygaard IE, McCreery R, Brubaker L, Connolly A, Cundiff G, Weber AM et al (2004) Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 104(4):805–823PubMed
3.
go back to reference Miyazaki FS, Miyazaki DW (1994) Raz four-corner suspension for severe cystocele: poor results. Int Urogynecol J 5:94–97CrossRef Miyazaki FS, Miyazaki DW (1994) Raz four-corner suspension for severe cystocele: poor results. Int Urogynecol J 5:94–97CrossRef
4.
go back to reference Kohli N, Sze EHM, Roat TW, Karram MM (1996) Incidence of recurrent cystocele after anterior colporrhaphy with or without concomitant transvaginal needle suspension. Am J Obstet Gynecol 175:1476–1482PubMedCrossRef Kohli N, Sze EHM, Roat TW, Karram MM (1996) Incidence of recurrent cystocele after anterior colporrhaphy with or without concomitant transvaginal needle suspension. Am J Obstet Gynecol 175:1476–1482PubMedCrossRef
5.
go back to reference Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomised trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1306PubMedCrossRef Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomised trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1306PubMedCrossRef
6.
go back to reference Sand PK, Koduri S, Lobel RW, Winkler HA, Tomezsko J, Culligan PJ et al (2001) Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol 184:1357–1364PubMedCrossRef Sand PK, Koduri S, Lobel RW, Winkler HA, Tomezsko J, Culligan PJ et al (2001) Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol 184:1357–1364PubMedCrossRef
7.
go back to reference Julian TM (1996) The efficacy or Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol 175:1472–1475PubMedCrossRef Julian TM (1996) The efficacy or Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol 175:1472–1475PubMedCrossRef
9.
go back to reference Flood CG, Drutz HP, Waja L (1998) Anterior colporraphy reinforced with Marlex mesh for the treatment of cystoceles. Int Urogynecol J 9:200–204CrossRef Flood CG, Drutz HP, Waja L (1998) Anterior colporraphy reinforced with Marlex mesh for the treatment of cystoceles. Int Urogynecol J 9:200–204CrossRef
10.
go back to reference Mage P (1999) Interposition of a synthetic mesh by vaginal approach in the cure of genital prolapse. J Gynecol Obstet Biol Reprod (Paris) 28(8):825–829 Mage P (1999) Interposition of a synthetic mesh by vaginal approach in the cure of genital prolapse. J Gynecol Obstet Biol Reprod (Paris) 28(8):825–829
11.
go back to reference Migliari R, De Angelis M, Madeddu G, Verdacchi T (2000) Tension-free vaginal mesh repair for anterior vaginal wall prolapse. Eur Urol 38:151–155PubMedCrossRef Migliari R, De Angelis M, Madeddu G, Verdacchi T (2000) Tension-free vaginal mesh repair for anterior vaginal wall prolapse. Eur Urol 38:151–155PubMedCrossRef
12.
go back to reference Hardiman P, Oyawoye S, Browning J (2000) Cystocele repair using polypropylene mesh. Br J Obstet Gynaecol 107:825–826 Hardiman P, Oyawoye S, Browning J (2000) Cystocele repair using polypropylene mesh. Br J Obstet Gynaecol 107:825–826
13.
go back to reference Sergent F, Marpeau L (2003) Prosthetic restoration of the pelvic diaphragm in genital urinary prolapse surgery trans-obturator and infracoccygeal hammock technique. J Gynecol Obstet Biol Reprod (Paris) 32(2):120–126 Sergent F, Marpeau L (2003) Prosthetic restoration of the pelvic diaphragm in genital urinary prolapse surgery trans-obturator and infracoccygeal hammock technique. J Gynecol Obstet Biol Reprod (Paris) 32(2):120–126
14.
go back to reference Adhoute F, Soyeur L, Pariente JL, Le Guillou M, Ferriere JM (2004) Use of transvaginal polypropylene mesh (Gynemesh) for the treatment of pelvic floor disorders in women. Prospective study in 52 patients. Prog Urol 14(2):192–196PubMed Adhoute F, Soyeur L, Pariente JL, Le Guillou M, Ferriere JM (2004) Use of transvaginal polypropylene mesh (Gynemesh) for the treatment of pelvic floor disorders in women. Prospective study in 52 patients. Prog Urol 14(2):192–196PubMed
15.
go back to reference Shah DK, Paul EM, Rastinehad AR, Eisenberg ER, Baldani GH (2004) Short-term outcome analysis of total pelvis reconstruction with mesh: the vaginal approach. J Urol 171(1):261–263PubMedCrossRef Shah DK, Paul EM, Rastinehad AR, Eisenberg ER, Baldani GH (2004) Short-term outcome analysis of total pelvis reconstruction with mesh: the vaginal approach. J Urol 171(1):261–263PubMedCrossRef
16.
go back to reference Dwyer PL, O’Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. Br J Obstet Gynaecol 111:831–836 Dwyer PL, O’Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. Br J Obstet Gynaecol 111:831–836
17.
go back to reference Milani R, Salvatore S, Soligo M, Pifarotti P, Meschia M, Cortese M (2004) Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. Br J Obstet Gynaecol 111:1–5 Milani R, Salvatore S, Soligo M, Pifarotti P, Meschia M, Cortese M (2004) Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh. Br J Obstet Gynaecol 111:1–5
18.
go back to reference de Tayrac R, Chauveaud-Lambling A, Fernandez D, Fernandez H (2003) Quality of life instruments for women with pelvic organ prolapse. J Gynecol Obstet Biol Reprod (Paris) 32:503–523 de Tayrac R, Chauveaud-Lambling A, Fernandez D, Fernandez H (2003) Quality of life instruments for women with pelvic organ prolapse. J Gynecol Obstet Biol Reprod (Paris) 32:503–523
19.
go back to reference Barber MD, Kuchibhatla MN, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395PubMedCrossRef Barber MD, Kuchibhatla MN, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395PubMedCrossRef
20.
go back to reference Amarenco G, Kerdraon J, Perrigot M (1992) [Echelle d’évaluation du handicap pelvien: mesure du handicap urinaire (MHU)] A urinary dysfunction measurement scale. In: Pelissier J, Coster P, Lopez S, Pares P (eds) Reeducation vésico-sphinctérienne et anorectale. Masson, Paris, pp 498–504 Amarenco G, Kerdraon J, Perrigot M (1992) [Echelle d’évaluation du handicap pelvien: mesure du handicap urinaire (MHU)] A urinary dysfunction measurement scale. In: Pelissier J, Coster P, Lopez S, Pares P (eds) Reeducation vésico-sphinctérienne et anorectale. Masson, Paris, pp 498–504
21.
go back to reference 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(2):75–80PubMed 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(2):75–80PubMed
22.
go back to reference Eglin G, Ska JM, Serres X (2003) Trans-obturator subvesical mesh. Tolerance and short-term results of 103 case continuous series. Gynecol Obstet Fertil 31:14–19PubMedCrossRef Eglin G, Ska JM, Serres X (2003) Trans-obturator subvesical mesh. Tolerance and short-term results of 103 case continuous series. Gynecol Obstet Fertil 31:14–19PubMedCrossRef
23.
go back to reference de Tayrac R, Picone O, Chauveaud-Lambling A, Fernandez H (2006) Two-year anatomical and functional assessment of transvaginal rectocele repair using a polypropylene mesh. Int Urogynecol J Pelvic Floor Dysfunct 17(2):100–105PubMedCrossRef de Tayrac R, Picone O, Chauveaud-Lambling A, Fernandez H (2006) Two-year anatomical and functional assessment of transvaginal rectocele repair using a polypropylene mesh. Int Urogynecol J Pelvic Floor Dysfunct 17(2):100–105PubMedCrossRef
24.
go back to reference Petros PE (2001) Vault prolapse II: restoration of dynamic vaginal supports by infracoccygeal sacropexy, an axial day-case vaginal procedure. Int Urogynecol J Pelvic Floor Dysfunct 12:296–303PubMedCrossRef Petros PE (2001) Vault prolapse II: restoration of dynamic vaginal supports by infracoccygeal sacropexy, an axial day-case vaginal procedure. Int Urogynecol J Pelvic Floor Dysfunct 12:296–303PubMedCrossRef
25.
go back to reference Arnaud JP, Hennekinne-Mucci S, Pessaux P, Tuech JJ, Aube C (2003) Ultrasound detection of visceral adhesion after intraperitoneal ventral hernia treatment: a comparative study of protected versus unprotected meshes. Hernia 7:85–88PubMedCrossRef Arnaud JP, Hennekinne-Mucci S, Pessaux P, Tuech JJ, Aube C (2003) Ultrasound detection of visceral adhesion after intraperitoneal ventral hernia treatment: a comparative study of protected versus unprotected meshes. Hernia 7:85–88PubMedCrossRef
Metadata
Title
Prolapse repair by vaginal route using a new protected low-weight polypropylene mesh: 1-year functional and anatomical outcome in a prospective multicentre study
Authors
Renaud de Tayrac
Guy Devoldere
Joël Renaudie
Pierre Villard
Olivier Guilbaud
Georges Eglin
The French Ugytex Study Group
Publication date
01-03-2007
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 3/2007
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-006-0135-5

Other articles of this Issue 3/2007

International Urogynecology Journal 3/2007 Go to the issue