Tension&amp;ndash;Free Vaginal Mesh Repair for Anterior Vaginal Wall Prolapse

Migliari, Roberto; Angelis, Michele De; Madeddu, Giuliana; Verdacchi, Tiziano

doi:10.1159/000020272

Cited by 100 publications

(53 citation statements)

References 19 publications

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“…At a mean follow-up interval of 14 months, there were no patients with symptomatic stress incontinence after surgery, and a 10% rate of positive stress tests were found at the postoperative evaluation. Another series by Migliari et al [12] confirmed that in patients with moderate anterior vaginal prolapse and stress incontinence, a fourcorner anchored tension-free mesh in combination with a TVT operation effectively treated both conditions. Our results were consistent with these reports and confirmed the feasibility of the concomitant usage of a TVT operation with the anterior colporraphy procedure reinforced with four-corner anchored polypropylene mesh.…”

Section: Discussionmentioning

confidence: 92%

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Factors that affect recurrence after anterior colporrhaphy procedure reinforced with four-corner anchored polypropylene mesh

et al. 2004

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The purpose of this study was to evaluate the effectiveness of the anterior colporrhaphy procedure reinforced with four-corner anchored polypropylene mesh in patients with severe (stage III or IV) anterior vaginal prolapse. Thirty-eight consecutive women were enlisted for this prospective study. The procedure consisted of an extensive vaginal dissection to join the vesicovaginal and retropubic space and an anchoring of a polypropylene mesh patch between the two Arcus Tendineus Fasciae Pelvis in a tension-free manner. The mean age of the study group was 63 (33-80) years. The success rate was 87% (33/38) at a mean follow-up interval of 21 (12-29) months. A total of eight (100%) patients were also cured of concomitant stress incontinence (five overt and three occult type) with an additional tension-free vaginal tape (TVT) operation. During follow-up, there were five de-novo stress incontinence cases (16.7%) and four vaginal erosions of mesh (10.5%). Four clinical variables--diabetes mellitus, recurrent anterior vaginal prolapse, chronic cough and vaginal erosions of mesh--were found to have a significant correlation with an unsatisfactory surgical result with large values of hazard ratios found by survival analysis. We concluded that the anterior colporrhaphy procedure reinforced with four-corner anchored polypropylene mesh was effective for most, but failed in some patients who had specific risk factors within short convalescence periods. Concomitant stress incontinence can be successfully treated by a TVT operation in combination with the anterior colporrhaphy procedure reinforced with four-corner anchored polypropylene mesh. However, the anterior colporrhaphy procedure may itself have adverse effects on urethral sphincter function.

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Section: Discussionmentioning

confidence: 92%

“…The use of artificial mesh may theoretically improve the success of the anterior vaginal prolapse repair. Polypropylene mesh has been used in suburethral sling operations successfully [8,9] and, only recently, has been used as part of an anterior vaginal prolapse repair [1,10,11,12,13].…”

Section: Introductionmentioning

confidence: 99%

Factors that affect recurrence after anterior colporrhaphy procedure reinforced with four-corner anchored polypropylene mesh

et al. 2004

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“…Good results confirmed the feasibility of concomitant treatment of prolapse (anterior colporraphy) and incontinence (TVT) [13], and even if Jacquetin et al [14]observed normal micturition a rapid recovery is partly lost. Moreover, Migliari et al [15]proposed to use TVT alone to correct anterior prolapse, but a long follow–up is needed to confirm and validate this unusual clinical procedure for repairing a defect of the anterior vaginal wall with prolene tape.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Tension–Free Vaginal Tape Procedure

et al. 2001

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“…La reparación del prolapso vaginal anterior es un desafío para los ginecólogos, debido principalmente a la alta tasa de recurrencia. Para evaluar esto de forma adecuada se requiere un seguimiento prolongado, problema principal de los trabajos existentes (7,8,9).…”

Section: Discussionunclassified

Reparación De Prolapso Vaginal Anterior Con Malla De Prolene

et al. 2007

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: La reparación del prolapso vaginal anterior presenta una alta tasa de recurrencia. La colporrafia anterior con malla de prolene es una buena alternativa quirúrgica que ha obtenido buenos resultados a largo plazo. Objetivo: Evaluar el resultado anatómico y la evolución de la colporrafia anterior con malla de prolene. Método: Estudio de cohorte prospectivo para evaluar el resultado quirúrgico. Resultados: Ingresaron 35 pacientes con una edad promedio de 61,4 años; 85,7% de ellas estaba en postmenopausia y 3% utilizaba terapia hormonal de reemplazo. La principal patología asociada fue la incontinencia de orina de esfuerzo (54,3%). El estado del piso pelviano preoperatorio correspondió a 31,4% cistocele grado II, 48,6% cistocele grado III y 20% cistocele grado IV. Se asoció prolapso uterino en 88,6% de los casos y 74,3% con prolapso de la pared posterior. No hubo complicaciones intraoperatorias. Hubo complicaciones postoperatorias en 4 pacientes (11,4%). Una paciente presentó erosión de la malla (2,9%). El seguimiento fue de 1 a 11 meses. En la evaluación postoperatoria de las pacientes con cistocele grado II 80% corrigió a grado 0; para cistocele grado III 72% corrigió a grado 0. Un 11% llegó a grado I y 17% grado II. Para el grupo con cistocele grado IV, 71% resultó en grado 0 y 29% grado II. Conclusión: La técnica presentada solucionó un severo problema de calidad de vida de las pacientes afectadas. Se requiere un mayor número de casos y tiempo de seguimiento para su recomendación definitiva. PALABRAS CLAVE: Prolapso vaginal anterior, malla de prolene, cistocele SUMMARYBackground: Repair of anterior vaginal prolapse present a high rate of recurrence. Anterior colporrhaphy plus prolene mesh is a surgical option with optimal long term results. Objective: To evaluate anatomical results and evolution of anterior colporrhaphy with prolene mesh. Method: A prospective cohort study was made to evaluate the surgical outcomes. Results: 35 patients were recruited with a median age of 61.4 years. 85.7% of them were in postmenopausal status and 3% were using hormone replacement therapy. Stress urinary incontinence was associated in 54.3% of the cases. The pelvic floor stage at entry was 31.4% cysthocele stage II, 48.6% stage III and 20% cysthocele stage IV. Uterine prolapse was present in 88.6% of cases and the posterior wall was compromised in 74.3%. There were no intraoperatory complications. Postoperatory complications occurred in 4 patients (11.4%). Only in one case the mesh eroded (2.9%). The follow up was from 1 to 11 months. Of the patients with cysthocele stage II at the moment of evaluation, 80% were at stage 0. For cysthocele stage III 72% turned to stage 0. 11% turned to stage I and 17% to stage II. The cases that

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Tension–Free Vaginal Mesh Repair for Anterior Vaginal Wall Prolapse

Cited by 100 publications

References 19 publications

Factors that affect recurrence after anterior colporrhaphy procedure reinforced with four-corner anchored polypropylene mesh

Factors that affect recurrence after anterior colporrhaphy procedure reinforced with four-corner anchored polypropylene mesh

Evaluation of Tension–Free Vaginal Tape Procedure

Reparación De Prolapso Vaginal Anterior Con Malla De Prolene

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Tension&ndash;Free Vaginal Mesh Repair for Anterior Vaginal Wall Prolapse

Cited by 100 publications

References 19 publications

Factors that affect recurrence after anterior colporrhaphy procedure reinforced with four-corner anchored polypropylene mesh

Factors that affect recurrence after anterior colporrhaphy procedure reinforced with four-corner anchored polypropylene mesh

Evaluation of Tension&ndash;Free Vaginal Tape Procedure

Reparación De Prolapso Vaginal Anterior Con Malla De Prolene

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Product

Resources

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Tension–Free Vaginal Mesh Repair for Anterior Vaginal Wall Prolapse

Evaluation of Tension–Free Vaginal Tape Procedure