A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse

Halaška, Michael; Maxova, Katerina; Sottner, Oldrich; Švabík, Kamil; Mlcoch, Michal; Kolařík, Dušan; Malá, Ivana; Krofta, Ladislav

doi:10.1016/j.ajog.2012.08.016

Cited by 70 publications

(48 citation statements)

References 32 publications

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“…Another complication with respect to mesh is exposure and erosion. Although there was no erosion or exposure in the present study, Halaska et al (27) reported that these rates are 20.8% and 37.5%, respectively. They treated these complications by surgical resection and local estrogen therapy.…”

Section: Discussioncontrasting

confidence: 62%

Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

Şentürk¹,

Güraslan²,

Çakmak³

et al. 2015

J Turkish German Gynecol Assoc

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Objective:The aim of this study was to evaluate the results of bilateral sacrospinous fixation (SSF), which was performed with surgical mesh interposition and bilateral vaginal repair. Twenty-two patients underwent SSF between 2010 and, and the results were evaluated retrospectively. The results at preoperative and postoperative 6 th , 12 th , and 18 th months of the pelvic organ prolapse quantification system (POP-Q) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) were compared using Friedman and Wilcoxon Signed Ranks tests. Values of p<0.05 and <0.01 were considered statistically significant. Material and Methods: Results:According to the POP-Q, significant healing was observed on all vaginal vault points (p=0.001), and no prolapse was observed until the 18-month follow-up stage. There were also prominent patients who felt satisfactory with respect to their sexual life according to . Conclusion:This technique appears to provide an adequate clinical resolution, and it may be the primary surgical option for women with pelvic organ prolapse. (J Turk Ger Gynecol Assoc 2015; 16: 102-6) Keywords: Pelvic organ prolapse, surgical mesh, vaginal vault Received: 29 December, 2014 Accepted: 08 March, 2015 Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up Abstract(PISQ-12) forms were completed. In addition, all patients were evaluated with Pap smear, and transvaginal ultrasonography was performed to evaluate endometrial thickness in postmenopausal patients. The operation time and the intraoperative and postoperative complications were recorded. All patients were re-examined according to the POP-Q system, and PISQ-12 forms were completed at 6, 12, and 18 months postoperatively (12). Treatment failure was defined as the presence of more than stage 1 prolapse. All surgeries were conducted under spinal anesthesia by a single surgeon experienced in pelvic floor surgery. Foley catheter was removed 6h after surgery. Postvoiding residual volume was evaluated by the Foley catheter, and PVR of less than 50 ml is considered to constitute adequate bladder emptying (13). Postvoidal residual volume was evaluated only in patients with stress urinary incontinence. All patients were discharged from the hospital on postoperative day 2. There was no necessary approval of the local ethic community because of the retrospective design of the study.The procedure was initiated with saline infusion from the posterior vaginal wall towards the ischial spine under the mucosa. After the initial midline incision was made on the posterior vaginal wall, digital blunt dissection of the coccygeus muscle was performed to access the sacrospinous ligament. The adipose tissue overlying the coccygeus muscle was removed to completely expose the sacrospinous ligament. A polypropylene suture (Prolen®; Ethicon, Norderstedt, Germany) (no:1) was bilaterally placed on the sacrospinous ligament. The tips of the 5×1.5 cm polypropylene mesh (Prolen®; Ethicon, Norderstedt, Germany) were suspended over th...

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Section: Discussioncontrasting

confidence: 62%

Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

Şentürk¹,

Güraslan²,

Çakmak³

et al. 2015

J Turkish German Gynecol Assoc

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“…This rate is higher than that reported by other authors with a follow-up of 1 year, which ranged from 7.4 to 16.9% [17, 19]. However, half of the recurrences observed in our study were asymptomatic and only 3.6% of patients required further POP surgery, a rate closer to that reported by those authors [17, 19].…”

Section: Discussioncontrasting

confidence: 55%

“…The most frequently reported mesh-related complication is vaginal mesh exposure, with reported rates as high as 20% [17, 19]. However, in most cases, vaginal mesh exposures can be addressed largely through minimally invasive procedures [19-21].…”

Section: Discussionmentioning

confidence: 99%

“…[16] However, only women with primary anterior or posterior prolapse were included in this study, so the results are not generalizable to patients with apical or recurrent prolapse as patients included in our study. Although the results of several randomized controlled trials in patients with apical prolapse have shown greater benefits in terms of anatomic cure rate and prolapse-related quality of life in the mesh group [17], other authors have reported no differences regarding anatomic or symptomatic recurrences [18]. According to the latest Cochrane review [15], there is little or no difference between surgery with or without mesh in terms of awareness of prolapse and the need for repeat surgery for POP.…”

Section: Discussionmentioning

confidence: 99%

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Pelvic Organ Prolapse Repair with Mesh: Mid-Term Efficacy and Complications

et al. 2018

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Introduction: Our aim was to assess the efficacy and complications of pelvic organ prolapse (POP) correction with transvaginal mesh (TVM). Materials and Methods: We retrospectively assessed patients who had undergone a repair of an apical (primary or recurrent) or recurrent POP using TVM in our department since 2007. Meshes used were Prolift®, Elevate®, and Surelift®. Satisfaction with surgery was assessed on a 0–10 scale. Results: A total of 83 patients were included (33 Prolift®, 36 Elevate®, 14 Surelift®), with a mean age of 67.8 ± 9.7 years. Eighteen (21.6%) patients underwent a recurrent POP correction. Follow-up was 49 ± 34 months. Twelve (14.4%) symptomatic recurrences were identified, 3 of which required further surgery. Satisfaction was 8.7. Four (4.8%) vaginal exposures were detected, 2 of which required partial mesh removal. Three (3.6%) cases of dyspareunia and 1 (1.2%) case of mild pelvic pain were reported, which did not require further treatment. Conclusion: The use of TVM for apical or recurrent POP repair is effective and is associated with a high satisfaction rate while complications are infrequent.

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“…Apical correction may play a role in the onset of postoperative stress urinary incontinence, and it would be interesting to correlate the rates with point-C correction. Postoperative stress urinary incontinence rates using the Prolift system vary between 4.5 % and 35 % [29,30].…”

Section: Discussionmentioning

confidence: 99%

A retrospective comparison of two vaginal mesh kits in the management of anterior and apical vaginal prolapse: long-term results for apical fixation and quality of life

et al. 2016

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The use of the Elevate Ant mesh was associated with significantly better apical correction at 2 years. Function improved in both groups, but with a significantly better PFDI-20 score in the Elevate Ant group at 1 and 2 years. The postoperative stress urinary incontinence rate, however, tended to be greater in the Elevate Ant group. The results need confirming with longer follow-up of these cohorts and in randomized studies.

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A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse

Cited by 70 publications

References 32 publications

Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

Pelvic Organ Prolapse Repair with Mesh: Mid-Term Efficacy and Complications

A retrospective comparison of two vaginal mesh kits in the management of anterior and apical vaginal prolapse: long-term results for apical fixation and quality of life

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