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International Urogynecology Journal

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01-02-2010 | Original Article

Anterior vaginal mesh sacrospinous hysteropexy and posterior fascial plication for anterior compartment dominated uterovaginal prolapse

Authors: Benjamin Feiner, Lieke Gietelink, Christopher Maher

Published in: International Urogynecology Journal | Issue 2/2010

Abstract

Introduction and hypothesis

The surgical management of multi-compartment prolapse is challenging and often requires a combination of techniques. This study evaluates anterior vaginal mesh repair, sacrospinous hysteropexy and posterior fascial plication in women with anterior compartment dominated uterovaginal prolapse.

Methods

Consecutive women who underwent the aforementioned surgery were prospectively evaluated. Main outcome measures included objective (pelvic organ prolapse quantification stage <2) and subjective success rates, patient satisfaction, functional outcomes and complications.

Results

One hundred and seventeen women were eligible, and 100 agreed to participate. At 12 months, objective success rate at the anterior compartment was 87% and at all compartments, 75%. Subjective success was 84%, and mean patient satisfaction was 8.5/10. There were no stage 3 or 4 recurrences at any site.

Conclusions

The combination of anterior vaginal mesh, sacrospinous hysteropexy and posterior fascial plication is reasonably effective in restoring the anatomy and achieving favourable bladder, bowel and sexual function.

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 184:1357–1362 discussion 1362–4CrossRefPubMed

Weber AM, Walters MD, Piedmonte MR, Ballard LA (2001) Anterior colporrhaphy: a randomized trial of three surgical techniques. Am J Obstet Gynecol 185:1299–1304 discussion 1304–6CrossRefPubMed

Nguyen JN, Burchette RJ (2008) Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol 111:891–898PubMed

Sivaslioglu AA, Unlubilgin E, Dolen I (2008) A randomized comparison of polypropylene mesh surgery with site-specific surgery in the treatment of cystocoele. Int Urogynecol J Pelvic Floor Dysfunct 19:467–471CrossRefPubMed

Nieminen K, Hiltunen R, Heiskanen E, Takala T, Niemi K, Merikari M et al (2008) Symptom resolution and sexual function after anterior vaginal wall repair with or without polypropylene mesh. Int Urogynecol J Pelvic Floor Dysfunct 19:1611–1616CrossRefPubMed

Brubaker L, Bump RC, Fynes M et al (2005) Surgery for pelvic organ prolapse. In: Abrams P, Cordozo L, Koury S, Wein A (eds) 3rd international consultation on incontinence. Health Publication Ltd, Paris

Shull BL (1999) Pelvic organ prolapse: anterior, superior, and posterior vaginal segment defects. Am J Obstet Gynecol 181:6–11CrossRefPubMed

Toozs-Hobson P, Boos K, Cardozo L (1998) Management of vaginal vault prolapse. Br J Obstet Gynaecol 105:13–17PubMed

de Boer TA, Milani AL, Kluivers KB, Withagen MI, Vierhout ME (2009) The effectiveness of surgical correction of uterine prolapse: cervical amputation with uterosacral ligament plication (modified Manchester) versus vaginal hysterectomy with high uterosacral ligament plication. Int Urogynecol J Pelvic Floor Dysfunct. doi:10.1007/s00192-009-0945-3 PubMed

10.

Dietz V, de Jong J, Huisman M, Schraffordt Koops S, Heintz P, van der Vaart H (2007) The effectiveness of the sacrospinous hysteropexy for the primary treatment of uterovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 18:1271–1276CrossRefPubMed

11.

Maher CF, Murray CJ, Carey MP, Dwyer PL, Ugoni AM (2001) Iliococcygeus or sacrospinous fixation for vaginal vault prolapse. Obstet Gynecol 98:40–44CrossRefPubMed

12.

van Brummen HJ, van de Pol G, Aalders CI, Heintz AP, van der Vaart CH (2003) Sacrospinous hysteropexy compared to vaginal hysterectomy as primary surgical treatment for a descensus uteri: effects on urinary symptoms. Int Urogynecol J Pelvic Floor Dysfunct 14:350–355 discussion 355CrossRefPubMed

13.

Collinet P, Belot F, Debodinance P, Ha Duc E, Lucot JP, Cosson M (2006) Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors. Int Urogynecol J Pelvic Floor Dysfunct 17:315–320CrossRefPubMed

14.

Maher CF, Qatawneh AM, Baessler K, Schluter PJ (2004) Midline rectovaginal fascial plication for repair of rectocele and obstructed defecation. Obstet Gynecol 104:685–689PubMed

15.

Baessler K, O’Neill SM, Maher CF, Battistutta D (2009) Australian pelvic floor questionnaire: a validated interviewer-administered pelvic floor questionnaire for routine clinic and research. Int Urogynecol J Pelvic Floor Dysfunct 20:149–158CrossRefPubMed

16.

Hiltunen R, Nieminen K, Takala T, Heiskanen E, Merikari M, Niemi K et al (2007) Low-weight polypropylene mesh for anterior vaginal wall prolapse: a randomized controlled trial. Obstet Gynecol 110:455–462PubMed

17.

Hinoul P, Ombelet WU, Burger MP, Roovers JP (2008) A prospective study to evaluate the anatomic and functional outcome of a transobturator mesh kit (prolift anterior) for symptomatic cystocele repair. J Minim Invasive Gynecol 15:615–620CrossRefPubMed

18.

Dietz V, Huisman M, de Jong JM, Heintz PM, van der Vaart CH (2008) Functional outcome after sacrospinous hysteropexy for uterine descensus. Int Urogynecol J Pelvic Floor Dysfunct 19:747–752CrossRefPubMed

19.

Gauruder-Burmester A, Koutouzidou P, Tunn R (2009) Effect of vaginal polypropylene mesh implants on sexual function. Eur J Obstet Gynecol Reprod Biol 142:76–80CrossRefPubMed

20.

Debodinance P, Cosson M, Burlet G, Engrand JB, Delporte P, Boulogne M et al (1999) Tolerance of synthetic tissues and vaginal surgery. Report of 287 cases. J Gynecol Obstet Biol Reprod (Paris) 28:216–224

21.

de Tayrac R, Deffieux X, Al G, Al C-L, Fernandez H (2006) Long-term anatomical and functional assessment of trans-vaginal cystocele repair using a tension-free polypropylene mesh. Int Urogynecol J Pelvic Floor Dysfunct 17:483–488CrossRefPubMed

22.

Nieminen K, Huhtala H, Heinonen PK (2003) Anatomic and functional assessment and risk factors of recurrent prolapse after vaginal sacrospinous fixation. Acta Obstet Gynecol Scand 82:471–478CrossRefPubMed

23.

Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ (2004) Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Am J Obstet Gynecol 190:20–26CrossRefPubMed

Title: Anterior vaginal mesh sacrospinous hysteropexy and posterior fascial plication for anterior compartment dominated uterovaginal prolapse
Authors: Benjamin Feiner
Lieke Gietelink
Christopher Maher
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 2/2010
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-009-1012-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Anterior vaginal mesh sacrospinous hysteropexy and posterior fascial plication for anterior compartment dominated uterovaginal prolapse

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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