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Erschienen in: International Urogynecology Journal 1/2010

01.01.2010 | Original Article

Cystocele repair by transobturator four arms mesh: monocentric experience of first 123 patients

verfasst von: Cyril Eboue, Naama Marcus-Braun, Peter von Theobald

Erschienen in: International Urogynecology Journal | Ausgabe 1/2010

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Abstract

Introduction and hypothesis

The aims of the study were to evaluate the per- and post-operative complications and outcomes after cystocele repair with transobturator mesh.

Methods

A retrospective continuous series study was conducted over a period of 3 years. Clinical evaluation was up to 1 year with additional telephonic interview performed after 34 months on average. When stress urinary incontinence (SUI) was associated with the cystocele, it was treated with the same mesh.

Results

One hundred twenty-three patients were treated for cystocele. Per-operative complications occurred in six patients. After 1 year, erosion rate was 6.5%, and only three cystoceles recurred. After treatment of SUI with the same mesh, 87.7% restored continence. Overall patient’s satisfaction rate was 93.5%.

Conclusions

Treatment of cystocele using transobturator four arms mesh appears to reduce the risk of recurrence at 1 year, along with high rate of patient’s satisfaction. The transobturator path of the prosthesis arms seems devoid of serious per- and post-operative risks and allows restoring continence when SUI is present.
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Literatur
1.
Zurück zum Zitat 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
2.
Zurück zum Zitat Clark AL, Gregory T, Smith VJ, Edwards R (2003) Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 189:1261–1267CrossRefPubMed Clark AL, Gregory T, Smith VJ, Edwards R (2003) Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 189:1261–1267CrossRefPubMed
3.
Zurück zum Zitat Whiteside JL, Weber AM, Meyn LA, Walters MD (2004) Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 191:1533–1538CrossRefPubMed Whiteside JL, Weber AM, Meyn LA, Walters MD (2004) Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 191:1533–1538CrossRefPubMed
4.
Zurück zum Zitat Julian TM (1996) The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol 175:1472–1475CrossRefPubMed Julian TM (1996) The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. Am J Obstet Gynecol 175:1472–1475CrossRefPubMed
5.
Zurück zum Zitat Hugier J, Scali P (1958) Posterior suspension of the genital axis on the lumbosacral disk in the treatment of uterine prolapse. Presse Med 66:781–784 Hugier J, Scali P (1958) Posterior suspension of the genital axis on the lumbosacral disk in the treatment of uterine prolapse. Presse Med 66:781–784
6.
Zurück zum Zitat Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7:81–85 discussion 5–6CrossRefPubMed Ulmsten U, Henriksson L, Johnson P, Varhos G (1996) An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 7:81–85 discussion 5–6CrossRefPubMed
7.
Zurück zum Zitat Delorme E (2001) Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 11:1306–1313PubMed Delorme E (2001) Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 11:1306–1313PubMed
8.
Zurück zum Zitat Eglin G, Ska JM, Serres X (2003) Transobturator subvesical mesh. Tolerance and short-term results of a 103 case continuous series. Gynecol Obstet Fertil 31:14–19CrossRefPubMed Eglin G, Ska JM, Serres X (2003) Transobturator subvesical mesh. Tolerance and short-term results of a 103 case continuous series. Gynecol Obstet Fertil 31:14–19CrossRefPubMed
9.
Zurück zum Zitat Fatton B, Amblard J, Debodinance P, Cosson M, Jacquetin B (2007) Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (Prolift technique)—a case series multicentric study. Int Urogynecol J Pelvic Floor Dysfunct 18:743–752CrossRefPubMed Fatton B, Amblard J, Debodinance P, Cosson M, Jacquetin B (2007) Transvaginal repair of genital prolapse: preliminary results of a new tension-free vaginal mesh (Prolift technique)—a case series multicentric study. Int Urogynecol J Pelvic Floor Dysfunct 18:743–752CrossRefPubMed
10.
Zurück zum Zitat Caquant F, Collinet P, Debodinance P, Berrocal J, Garbin O, Rosenthal C et al (2008) Safety of trans vaginal mesh procedure: retrospective study of 684 patients. J Obstet Gynaecol Res 34:449–456CrossRefPubMed Caquant F, Collinet P, Debodinance P, Berrocal J, Garbin O, Rosenthal C et al (2008) Safety of trans vaginal mesh procedure: retrospective study of 684 patients. J Obstet Gynaecol Res 34:449–456CrossRefPubMed
11.
Zurück zum Zitat Nauth MA, Fünfgeld C (2008) Correction of cystocele and stress incontinence with anterior transobturator mesh. Eur J Obstet Gynecol Reprod Biol 136:249–253CrossRefPubMed Nauth MA, Fünfgeld C (2008) Correction of cystocele and stress incontinence with anterior transobturator mesh. Eur J Obstet Gynecol Reprod Biol 136:249–253CrossRefPubMed
12.
Zurück zum Zitat Rane A, Kannan K, Barry C, Balakrishnan S, Lim Y, Corstiaans A (2008) Prospective study of the Perigee system for the management of cystocoeles—medium-term follow up. Aust NZ J Obstet Gynaecol 48:427–432CrossRef Rane A, Kannan K, Barry C, Balakrishnan S, Lim Y, Corstiaans A (2008) Prospective study of the Perigee system for the management of cystocoeles—medium-term follow up. Aust NZ J Obstet Gynaecol 48:427–432CrossRef
13.
Zurück zum Zitat Shippey S, Gutman RE, Quiroz LH, Handa VL (2008) Contemporary approaches to cystocele repair: a survey of AUGS members. J Reprod Med 53:832–836PubMed Shippey S, Gutman RE, Quiroz LH, Handa VL (2008) Contemporary approaches to cystocele repair: a survey of AUGS members. J Reprod Med 53:832–836PubMed
14.
Zurück zum Zitat Petros PE, Ulmsten UI (1993) An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol Suppl 153:1–93PubMed Petros PE, Ulmsten UI (1993) An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol Suppl 153:1–93PubMed
15.
Zurück zum Zitat Stein TA, DeLancey JO (2008) Structure of the perineal membrane in females: gross and microscopic anatomy. Obstet Gynecol 111:686–693PubMed Stein TA, DeLancey JO (2008) Structure of the perineal membrane in females: gross and microscopic anatomy. Obstet Gynecol 111:686–693PubMed
16.
Zurück zum Zitat Shek KL, Dietz HP, Rane A, Balakrishnan S (2008) Transobturator mesh for cystocele repair: a short- to medium-term follow-up using 3D/4D ultrasound. Ultrasound Obstet Gynecol 32:82–86CrossRefPubMed Shek KL, Dietz HP, Rane A, Balakrishnan S (2008) Transobturator mesh for cystocele repair: a short- to medium-term follow-up using 3D/4D ultrasound. Ultrasound Obstet Gynecol 32:82–86CrossRefPubMed
17.
Zurück zum Zitat Nguyen JN, Burchette RJ (2008) Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol 111:891–898PubMed Nguyen JN, Burchette RJ (2008) Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol 111:891–898PubMed
18.
Zurück zum Zitat Sivaslioglu AA, Unlubilgin E, Dolen I (2008) A randomized comparison of polypropylene mesh surgery with site-specific surgery in the treatment of cystocele. Int Urogynecol J Pelvic Floor Dysfunct 19:467–471CrossRefPubMed Sivaslioglu AA, Unlubilgin E, Dolen I (2008) A randomized comparison of polypropylene mesh surgery with site-specific surgery in the treatment of cystocele. Int Urogynecol J Pelvic Floor Dysfunct 19:467–471CrossRefPubMed
19.
Zurück zum Zitat Birch C, Fynes MM (2002) The role of synthetic and biological prostheses in reconstructive pelvic floor surgery. Curr Opin Obstet Gynecol 14:527–535CrossRefPubMed Birch C, Fynes MM (2002) The role of synthetic and biological prostheses in reconstructive pelvic floor surgery. Curr Opin Obstet Gynecol 14:527–535CrossRefPubMed
20.
Zurück zum Zitat Klinge U, Junge K, Spellerberg B, Piroth C, Klosterhalfen B, Schumpelick V (2002) Do multifilament alloplastic meshes increase the infection rate? Analysis of the polymeric surface, the bacteria adherence, and the in vivo consequences in a rat model. J Biomed Mater Res 63:765–771CrossRefPubMed Klinge U, Junge K, Spellerberg B, Piroth C, Klosterhalfen B, Schumpelick V (2002) Do multifilament alloplastic meshes increase the infection rate? Analysis of the polymeric surface, the bacteria adherence, and the in vivo consequences in a rat model. J Biomed Mater Res 63:765–771CrossRefPubMed
21.
Zurück zum Zitat Dwyer PL, O’Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. BJOG 111:831–836CrossRefPubMed Dwyer PL, O’Reilly BA (2004) Transvaginal repair of anterior and posterior compartment prolapse with Atrium polypropylene mesh. BJOG 111:831–836CrossRefPubMed
22.
Zurück zum Zitat Bader G, Fauconnier A, Guyot B, Ville Y (2006) Use of prosthetic materials in reconstructive pelvic floor surgery. An evidence-based analysis. Gynecol Obstet Fertil 34:292–297CrossRefPubMed Bader G, Fauconnier A, Guyot B, Ville Y (2006) Use of prosthetic materials in reconstructive pelvic floor surgery. An evidence-based analysis. Gynecol Obstet Fertil 34:292–297CrossRefPubMed
23.
Zurück zum Zitat 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 17:315–320CrossRefPubMed 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 17:315–320CrossRefPubMed
24.
Zurück zum Zitat Mistrangelo E, Mancuso S, Nadalini C, Lijoi D, Costantini S (2007) Rising use of synthetic mesh in transvaginal pelvic reconstructive surgery: a review of the risk of vaginal erosion. J Minim Invasive Gynecol 14:564–569CrossRefPubMed Mistrangelo E, Mancuso S, Nadalini C, Lijoi D, Costantini S (2007) Rising use of synthetic mesh in transvaginal pelvic reconstructive surgery: a review of the risk of vaginal erosion. J Minim Invasive Gynecol 14:564–569CrossRefPubMed
25.
Zurück zum Zitat Achtari C, Hiscock R, O’Reilly BA, Schierlitz L, Dwyer PL (2005) Risk factors for mesh erosion after transvaginal surgery using polypropylene (Atrium) or composite polypropylene/polyglactin 910 (Vypro II) mesh. Int Urogynecol J Pelvic Floor Dysfunct 16:389–394CrossRefPubMed Achtari C, Hiscock R, O’Reilly BA, Schierlitz L, Dwyer PL (2005) Risk factors for mesh erosion after transvaginal surgery using polypropylene (Atrium) or composite polypropylene/polyglactin 910 (Vypro II) mesh. Int Urogynecol J Pelvic Floor Dysfunct 16:389–394CrossRefPubMed
26.
Zurück zum Zitat Deffieux X, de Tayrac R, Huel C, Bottero J, Gervaise A, Bonnet K et al (2007) Vaginal mesh erosion after transvaginal repair of cystocele using Gynemesh or Gynemesh-Soft in 138 women: a comparative study. Int Urogynecol J Pelvic Floor Dysfunct 18:73–79CrossRefPubMed Deffieux X, de Tayrac R, Huel C, Bottero J, Gervaise A, Bonnet K et al (2007) Vaginal mesh erosion after transvaginal repair of cystocele using Gynemesh or Gynemesh-Soft in 138 women: a comparative study. Int Urogynecol J Pelvic Floor Dysfunct 18:73–79CrossRefPubMed
27.
Zurück zum Zitat Bent AE, Ostergard DR, Zwick-Zaffuto M (1993) Tissue reaction to expanded polytetrafluoroethylene suburethral sling for urinary incontinence: clinical and histologic study. Am J Obstet Gynecol 169:1198–1204PubMed Bent AE, Ostergard DR, Zwick-Zaffuto M (1993) Tissue reaction to expanded polytetrafluoroethylene suburethral sling for urinary incontinence: clinical and histologic study. Am J Obstet Gynecol 169:1198–1204PubMed
28.
Zurück zum Zitat Sergent F, Resch B, Diguet A, Verspyck E, Marpeau L (2006) Cystocele and stress urinary incontinence: assessment of a total treatment by monoprosthesis. Gynecol Obstet Fertil 34:385–392CrossRefPubMed Sergent F, Resch B, Diguet A, Verspyck E, Marpeau L (2006) Cystocele and stress urinary incontinence: assessment of a total treatment by monoprosthesis. Gynecol Obstet Fertil 34:385–392CrossRefPubMed
29.
Zurück zum Zitat Spinosa JP, Dubuis PY, Riederer B (2005) Transobturator surgery for female urinary continence: from outside to inside or from inside to outside: a comparative anatomic study. Prog Urol 15:700–706PubMed Spinosa JP, Dubuis PY, Riederer B (2005) Transobturator surgery for female urinary continence: from outside to inside or from inside to outside: a comparative anatomic study. Prog Urol 15:700–706PubMed
30.
Zurück zum Zitat Warner MA, Martin JT, Schroeder DR, Offord KP, Chute CG (1994) Lower-extremity motor neuropathy associated with surgery performed on patients in a lithotomy position. Anesthesiology 81:6–12CrossRefPubMed Warner MA, Martin JT, Schroeder DR, Offord KP, Chute CG (1994) Lower-extremity motor neuropathy associated with surgery performed on patients in a lithotomy position. Anesthesiology 81:6–12CrossRefPubMed
Metadaten
Titel
Cystocele repair by transobturator four arms mesh: monocentric experience of first 123 patients
verfasst von
Cyril Eboue
Naama Marcus-Braun
Peter von Theobald
Publikationsdatum
01.01.2010
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 1/2010
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-009-0993-8

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