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International Urogynecology Journal
Published in: International Urogynecology Journal 7/2022

29-09-2021 | Stress Incontinence | Original Article

Transvaginal repair of anterior vaginal wall prolapse with polyvinylidene fluoride (PVDF) mesh: an alternative for previously restricted materials?

Authors: Mohammad-Javad Eslami, Mahtab Zargham, Farshad Gholipour, Mohammadreza Hajian, Katayoun Bakhtiari, Sakineh Hajebrahimi, Melina Eghbal, Ziba Farajzadegan

Published in: International Urogynecology Journal | Issue 7/2022

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Abstract

Introduction and hypothesis

To study the mid-term safety and functional outcomes of transvaginal anterior vaginal wall prolapse repair using polyvinylidene fluoride (PVDF) mesh (DynaMesh®-PR4) by the double trans-obturator technique (TOT).

Methods

Between 2015 and 2020, we prospectively included women with symptomatic high-stage anterior vaginal wall prolapse with or without uterine prolapse or stress urinary incontinence (SUI) in the study. The patients underwent transvaginal repair of the prolapse using PVDF mesh in two medical centers. We followed all patients for at least 12 months. We recorded the characteristics of vaginal and sexual symptoms, urinary incontinence, and prolapse stage pre- and postoperatively using International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS), International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF), and Pelvic Organ Prolapse Quantification (POP-Q) system, respectively.

Results

One hundred eight women were included in the final analysis with a mean follow-up time of 34.5 ± 18.6 months. The anatomical success was achieved in 103 (95.4%) patients. There was a significant improvement in patients’ vaginal symptoms, urinary incontinence, and quality of life scores postoperatively (p < 0.0001). Only six patients (5.5%) had mesh extrusion, five of whom were managed successfully. The total rates of complications and de novo urinary symptoms were 21.3% and 7.4%, respectively. Significant pain was reported in 17 cases (15.7%).

Conclusion

Our findings show that using PVDF mesh in the double TOT technique for anterior vaginal wall prolapse repair is a safe procedure with high anatomic and functional success rates and acceptable complication rates in mid-term follow-up.
Literature
1.
Garshasbi A, Faghih-Zadeh S, Falah N. The status of pelvic supporting organs in a population of Iranian women 18–68 years of age and possible related factors. Archives of Iranian Medicine. 2006;9(2):124–8.PubMed
2.
Illiano E, Giannitsas K, Zucchi A, Di Biase M, Del Zingaro M, Bini V, et al. Sacrocolpopexy for posthysterectomy vaginal vault prolapse: long-term follow-up. Int Urogynecol J. 2016;27(10):1563–9.CrossRef
3.
Dietz HP. Pelvic organ prolapse-a review. Aust Fam Physician. 2015;44(7):446.PubMed
4.
Barski D, Otto T, Gerullis H. Systematic review and classification of complications after anterior, posterior, apical, and total vaginal mesh implantation for prolapse repair. Surg Technol Int. 2014;24:217–24.PubMed
5.
Roman S, Mangir N, Hympanova L, Chapple CR, Deprest J, MacNeil S. Use of a simple in vitro fatigue test to assess materials used in the surgical treatment of stress urinary incontinence and pelvic organ prolapse. Neurourol Urodyn. 2019;38(1):107–15.CrossRef
6.
Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013;4.
7.
Ganj FA, Ibeanu OA, Bedestani A, Nolan TE, Chesson RR. Complications of transvaginal monofilament polypropylene mesh in pelvic organ prolapse repair. Int Urogynecol J. 2009;20(8):919–25.CrossRef
8.
Nieminen K, Hiltunen R, Takala T, Heiskanen E, Merikari M, Niemi K, et al. Outcomes after anterior vaginal wall repair with mesh: a randomized, controlled trial with a 3 year follow-up. American journal of obstetrics and gynecology. 2010;203(3):235. e1-. e8.
9.
Clemons JL, Aguilar VC, Tillinghast TA, Jackson ND, Myers DL. Patient satisfaction and changes in prolapse and urinary symptoms in women who were fitted successfully with a pessary for pelvic organ prolapse. Am J Obstet Gynecol. 2004;190(4):1025–9.CrossRef
10.
Nguyen JN, Burchette RJ. Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol. 2008;111(4):891–8.CrossRef
11.
Klinge U, Klosterhalfen B, Öttinger A, Junge K, Schumpelick V. PVDF as a new polymer for the construction of surgical meshes. Biomaterials. 2002;23(16):3487–93.CrossRef
12.
Klink C, Junge K, Binnebösel M, Alizai H, Otto J, Neumann U, et al. Comparison of long-term biocompability of PVDF and PP meshes. J Investig Surg. 2011;24(6):292–9.CrossRef
13.
Göretzlehner U, Müllen A. PVDF as an implant material in urogynaecology. J Biomaterialien. 2009;8(S1):28–9.
14.
Barski D, Arndt C, Gerullis H, Yang J, Boros M, Otto T, et al. Transvaginal PVDF-mesh for cystocele repair: a cohort study. Int J Surg. 2017;39:249–54.CrossRef
15.
Balsamo R, Illiano E, Zucchi A, Natale F, Carbone A, De Sio M, et al. Sacrocolpopexy with polyvinylidene fluoride mesh for pelvic organ prolapse: mid term comparative outcomes with polypropylene mesh. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2018;220:74–8.CrossRef
16.
Pourmomeny AA, Fouladi F, Sedighimehr N, Zargham M. The Persian version of the International Consultation on Incontinence Questionnaire Vaginal Symptoms translation, validation, and reliability study. J Res Med Sci. 2021;Ahead of Print.
17.
Hajebrahimi S, Nourizadeh D, Hamedani R, Pezeshki MZ. Validity and reliability of the international consultation on incontinence questionnaire-urinary incontinence short form and its correlation with urodynamic findings. Urol J. 2012;9(4):685–90.PubMed
18.
Persu C, Chapple C, Cauni V, Gutue S, Geavlete P. Pelvic organ prolapse quantification system (POP–Q)–a new era in pelvic prolapse staging. Journal of medicine and life. 2011;4(1):75–81.PubMedPubMedCentral
19.
Palma P, Riccetto C, Prudente A, Dalphorno F, Delroy C, Castro R, et al. Monoprosthesis for anterior vaginal prolapse and stress urinary incontinence: midterm results of an international multicentre prospective study. Int Urogynecol J. 2011;22(12):1535–41.CrossRef
20.
Otto T, Klosterhalfen B, Klinge U, Boros M, Ysebaert D, Williams K. Implants in Urogynecology. Biomed Res Int. 2015;2015.
21.
Su T-H, Lau H-H, Huang W-C, Hsieh C-H, Chang R-C, Su C-H. Single-incision mesh repair versus traditional native tissue repair for pelvic organ prolapse: results of a cohort study. Int Urogynecol J. 2014;25(7):901–8.CrossRef
22.
Vitale SG, Lagana AS, Gulino FA, Tropea A, Tarda S. Prosthetic surgery versus native tissue repair of cystocele: literature review. Updat Surg. 2016;68(4):325–9.CrossRef
23.
Ismail SI, Bain C, Hagen S. Oestrogens for treatment or prevention of pelvic organ prolapse in postmenopausal women. The Cochrane database of systematic reviews. 2010(9):Cd007063.
24.
Masden D, Felder JM III, Bhanot P, Attinger CE. Abdominal wall reconstruction with implantable meshes. J Long-Term Eff Med Implants. 2011;21(1):25–50.CrossRef
25.
Sharifiaghdas F, Daneshpajooh A, Mirzaei M. Simultaneous treatment of anterior vaginal wall prolapse and stress urinary incontinence by using transobturator four arms polypropylene mesh. Korean journal of urology. 2015;56(12):811–6.CrossRef
26.
Gerullis H, Klosterhalfen B, Borós M, Lammers B, Eimer C, Georgas E, et al. IDEAL in meshes for prolapse, urinary incontinence, and hernia repair. Surg Innov. 2013;20(5):502–8.CrossRef
27.
DeLancey JO. Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol. 1992;166(6):1717–28.CrossRef
28.
Geller EJ. Prevention and management of postoperative urinary retention after urogynecologic surgery. Int J Women's Health. 2014;6:829–38.CrossRef
29.
Zargham M, Saberi N, Khorrami MH, Mohamadi M, Nourimahdavi K, Izadpanahi MH. Stress urinary incontinence and pelvic organ prolapse correction by single incision and using Monoprosthesis: three-year follow-up. Advanced Biomedical Research. 2018;7(1):159.CrossRef
30.
Rajshekhar S, Mukhopadhyay S, Klinge U. Mesh for prolapse surgery: why the fuss? Post Reproductive Health. 2015;21(2):69–74.CrossRef
31.
Rachaneni S, Latthe P. Does preoperative urodynamics improve outcomes for women undergoing surgery for stress urinary incontinence? A systematic review and meta-analysis. BJOG. 2015;122(1):8–16.CrossRef
32.
Van Leijsen SAL, Kluivers KB, Mol BWJ, Milani AL, Roovers J-PW, den Boon J, et al. Value of urodynamics before stress urinary incontinence surgery: a randomized controlled trial. Obstet Gynecol. 2013;121(5):999–1008.CrossRef
Metadata
Title
Transvaginal repair of anterior vaginal wall prolapse with polyvinylidene fluoride (PVDF) mesh: an alternative for previously restricted materials?
Authors
Mohammad-Javad Eslami
Mahtab Zargham
Farshad Gholipour
Mohammadreza Hajian
Katayoun Bakhtiari
Sakineh Hajebrahimi
Melina Eghbal
Ziba Farajzadegan
Publication date
29-09-2021
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 7/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-021-04977-7

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