Conventional fascial technique versus mesh repair for advanced pelvic organ prolapse: Analysis of recurrences in treated and untreated compartments

Abstract

117 women with severe pelvic organ prolapse (POP; stage > 2) were enrolled to elucidate a 24-month outcome of POP surgery, using conventional or mesh repair with 3 techniques. 59 patients underwent conventional repair and 58 underwent mesh repair. Two types of mesh were used: a trocar-guided transobturator polypropylene (Avaulta, Bard Inc.) and a porcine dermis mesh (Pelvisoft, Bard Inc.). Women with recurrences, who underwent previous unsuccessful conventional repair, were randomised. Primary outcome was the evaluation of anatomic failures (prolapse stage > 1) in treated and untreated compartments. Anatomic failure was observed in 11 of 58 patients (19%; CI 8.9-29) in the mesh group and in 16 of 59 patients (27.1%; p value = 0.3) in the conventional group. 9 of 11 failures in the mesh group (15.5%; CI 6.2-24.8) were observed in the untreated compartment (de novo recurrences), 14.3% in Pelvisoft and 16.7% in Avaulta arm, while only 1 recurrence in the untreated compartment (1.7%) was observed in the conventional group (odds ratio 10.6, p = 0.03).

The Comparison of Outcomes of Transvaginal Mesh Surgery with and without Midline Fascial Plication for the Treatment of Anterior Vaginal Prolapse: A Randomized Controlled Trial

“…The incidence of de novo pain and mesh exposure was 3.3% and 11.7%, respectively [ 19 ]. Another study recruited 117 women with POP who received mesh (Avaulta and Pelvisoft) and conventional fascial plication techniques [ 34 ]. The anatomical failure rates after 2 years of follow-up were 19 and 27% in the mesh and conventional technique group, respectively [ 34 ].…”

“…Another study recruited 117 women with POP who received mesh (Avaulta and Pelvisoft) and conventional fascial plication techniques [ 34 ]. The anatomical failure rates after 2 years of follow-up were 19 and 27% in the mesh and conventional technique group, respectively [ 34 ]. Another study recruited 41 patients with POP repaired by Avaulta™ or Avaulta Plus™ and found that both devices were effective, safe, and improved life quality [ 35 ].…”

Robotic lateral pelvic organ prolapse suspension of multicompartment vaginal prolapse

“…Position of the patient was described in our previous paper. [ 9 10 ] After introducing the da Vinci 0° optic, we placed the two 8-mm trocars in each iliac fossa, laterally about 5 cm above and 2 cm medial to the anterior superior iliac spine.…”