Skip to main content
Top
Published in: International Urogynecology Journal 4/2010

01-04-2010 | Original Article

Transvaginal polypropylene mesh versus sacrospinous ligament fixation for the treatment of uterine prolapse: 1-year follow-up of a randomized controlled trial

Authors: Eliana Duarte Lopes, Nucélio Luiz de Barros Moreira Lemos, Silvia da Silva Carramão, Jacqueline Leme Lunardelli, José Maria Cordeiro Ruano, Tsutomu Aoki, Antonio Pedro Flores Auge

Published in: International Urogynecology Journal | Issue 4/2010

Login to get access

Abstract

Introduction and hypothesis

The objective of this study was to compare the anatomical and quality of life outcomes of a posterior polypropylene mesh kit versus sacrospinous ligament fixation at the time of hysterectomy for the treatment of uterine prolapse.

Methods

Thirty-two women aged 50 to 75 years with stage III or IV (pelvic organ prolapse quantification system/International Continence Society) uterine prolapse were randomized into two groups (group 1: polypropylene mesh, Nazca R®, Promedon, Cordoba, Argentina; group 2: sacrospinous ligament fixation).

Results

At 12-month follow-ups, we observed the same anatomical results in both groups. The median operating time, intraoperative blood loss, and perioperative complications were also equal in both groups. There were five cases (35.71%) of mesh erosion, and prolapse of the anterior vaginal wall (cystocele) occurred in 50% of the patients.

Conclusions

Similar anatomical and quality of life outcomes were observed with polypropylene mesh and sacrospinous ligament fixation for the treatment of uterine prolapse. Complication rate was higher in the mesh group.
Literature
1.
go back to reference ACOG technical bulletin (1996) Pelvic organ prolapse. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 52:197–205CrossRef ACOG technical bulletin (1996) Pelvic organ prolapse. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 52:197–205CrossRef
2.
go back to reference Boyles SH, Weber AM, Meyn L (2003) Procedures for urinary incontinence in the United States, 1979–1997. Am J Obstet Gynecol 188:108–115CrossRefPubMed Boyles SH, Weber AM, Meyn L (2003) Procedures for urinary incontinence in the United States, 1979–1997. Am J Obstet Gynecol 188:108–115CrossRefPubMed
3.
go back to reference Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed
4.
go back to reference Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S (2007) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 18(3):CD004014 Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S (2007) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 18(3):CD004014
5.
go back to reference Shull BL (1999) Pelvic organ prolapse: anterior, superior, and posterior vaginal segment defects. Am J Obstet Gynecol 181:6–11CrossRefPubMed Shull BL (1999) Pelvic organ prolapse: anterior, superior, and posterior vaginal segment defects. Am J Obstet Gynecol 181:6–11CrossRefPubMed
6.
go back to reference 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 19:467–471CrossRef 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 19:467–471CrossRef
7.
go back to reference Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17CrossRefPubMed
8.
go back to reference Lemos NLBM, Auge APF, Lunardelli JL, Frade AB, Frade CL, Oliveira AL et al (2007) Optimizing pelvic organ prolapse research. Int Urogynecol J 18:609–611CrossRef Lemos NLBM, Auge APF, Lunardelli JL, Frade AB, Frade CL, Oliveira AL et al (2007) Optimizing pelvic organ prolapse research. Int Urogynecol J 18:609–611CrossRef
9.
go back to reference Lemos NLBM, Auge APF, Lunardelli JL, Carramão SS, Faria ALA, Aoki T (2008) Validation of the pelvic organ prolapse quantification index (POP-Q-I): a novel interpretation of the POP-Q system for optimization of POP research. Int Urogynecol J 19:995–997CrossRef Lemos NLBM, Auge APF, Lunardelli JL, Carramão SS, Faria ALA, Aoki T (2008) Validation of the pelvic organ prolapse quantification index (POP-Q-I): a novel interpretation of the POP-Q system for optimization of POP research. Int Urogynecol J 19:995–997CrossRef
10.
go back to reference Fonseca ESM, Camargo ALM, Castro RA, Sartori MGF, Fonseca MCM, Lima GR, Girão MJBC (2005) Validation of a quality of life questionnaire (King's health questionnaire) in Brazilian women with urinary incontinence. Rev Bras Ginecol Obstet 27:235–242 Fonseca ESM, Camargo ALM, Castro RA, Sartori MGF, Fonseca MCM, Lima GR, Girão MJBC (2005) Validation of a quality of life questionnaire (King's health questionnaire) in Brazilian women with urinary incontinence. Rev Bras Ginecol Obstet 27:235–242
11.
go back to reference Kelleher CJ, Cardozo LD, Khullar V, Salvatore S (1997) A new questionnaire to assess the quality of life of urinary incontinent women. BJOG 104:1374–1379CrossRef Kelleher CJ, Cardozo LD, Khullar V, Salvatore S (1997) A new questionnaire to assess the quality of life of urinary incontinent women. BJOG 104:1374–1379CrossRef
12.
go back to reference Jones HW (2003) Histerectomy. In: Rock JA, Jones HW (eds) TeLinde's operative gynecology. Lippincott Williams & Wilkins, Philadelphia, pp 799–828 Jones HW (2003) Histerectomy. In: Rock JA, Jones HW (eds) TeLinde's operative gynecology. Lippincott Williams & Wilkins, Philadelphia, pp 799–828
13.
go back to reference deTayrac R, Deffieux X, Gervaise A, Chauveaud-Lambling A, Fernandez H (2006) Long-term anatomical and functional assessment of trans-vaginal cystocele repair using a tension-free polypropylene mesh. Int Urogynecol J 17:483–488CrossRef deTayrac R, Deffieux X, Gervaise A, Chauveaud-Lambling A, Fernandez H (2006) Long-term anatomical and functional assessment of trans-vaginal cystocele repair using a tension-free polypropylene mesh. Int Urogynecol J 17:483–488CrossRef
14.
go back to reference de Tayrac R, Bader G, Deffieux X, Fazel A, Mathé M, Fernandez H (2006) A prospective randomized study comparing posterior IVS and sacrospinous suspension for the surgical treatment of uterine or vaginal vault prolapse. International Urogynecological Association (31st Annual Meeting), September, Athens (Greece), Abstract number 317 de Tayrac R, Bader G, Deffieux X, Fazel A, Mathé M, Fernandez H (2006) A prospective randomized study comparing posterior IVS and sacrospinous suspension for the surgical treatment of uterine or vaginal vault prolapse. International Urogynecological Association (31st Annual Meeting), September, Athens (Greece), Abstract number 317
15.
go back to reference Feiner B, Jelovsek JE, Maher C (2009) Efficacy and safety of transvaginal mesh kits in the treatment of prolapse of the vaginal apex: a systematic review. BJOG 116(1):15–24CrossRefPubMed Feiner B, Jelovsek JE, Maher C (2009) Efficacy and safety of transvaginal mesh kits in the treatment of prolapse of the vaginal apex: a systematic review. BJOG 116(1):15–24CrossRefPubMed
16.
go back to reference Svaslioglu AA, Unlubilgin E, Dölen I (2008) The multifilament polypropylene tape erosion trouble: tape structure vs surgical technique. Which one is the cause? Int Urogynecol J 19:417–420CrossRef Svaslioglu AA, Unlubilgin E, Dölen I (2008) The multifilament polypropylene tape erosion trouble: tape structure vs surgical technique. Which one is the cause? Int Urogynecol J 19:417–420CrossRef
17.
go back to reference 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(4):315–320CrossRefPubMed 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(4):315–320CrossRefPubMed
18.
go back to reference 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(1):20–26CrossRefPubMed 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(1):20–26CrossRefPubMed
19.
go back to reference Petros PEP (2007) The female pelvic floor. Springer Medizin Verlag, Heidelberg Petros PEP (2007) The female pelvic floor. Springer Medizin Verlag, Heidelberg
Metadata
Title
Transvaginal polypropylene mesh versus sacrospinous ligament fixation for the treatment of uterine prolapse: 1-year follow-up of a randomized controlled trial
Authors
Eliana Duarte Lopes
Nucélio Luiz de Barros Moreira Lemos
Silvia da Silva Carramão
Jacqueline Leme Lunardelli
José Maria Cordeiro Ruano
Tsutomu Aoki
Antonio Pedro Flores Auge
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 4/2010
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-009-1052-1

Other articles of this Issue 4/2010

International Urogynecology Journal 4/2010 Go to the issue