Skip to main content
Erschienen in: International Urogynecology Journal 12/2015

01.12.2015 | Original Article

Utero-vaginal suspension using bilateral vaginal anterior sacrospinous fixation with mesh: intermediate results of a cohort study

verfasst von: Vincent Letouzey, Daniela Ulrich, Eva Balenbois, Arnaud Cornille, Renaud de Tayrac, Brigitte Fatton

Erschienen in: International Urogynecology Journal | Ausgabe 12/2015

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

Pelvic organ prolapse is a major burden for the public health system, affecting up to 30 % of all women. One mesh kit has been introduced for pelvic organ prolapse surgery that can be inserted via a single anterior incision with the mesh arms driven through the sacrospinous ligament in a tension-free manner. The aim of this study was to describe the medium-term results of this vaginal mesh kit procedure for the combined treatment of the anterior vaginal wall and vault prolapse.

Methods

This is a longitudinal case series of patients undergoing an anterior mesh operation between 2009 and 2013. All patients presenting with symptomatic stage II prolapse or higher were included when a minimum follow-up of 12 months was achieved. A structured interview and clinical examination were performed pre- and postoperatively.

Results

One hundred and eighteen consecutive patients were operated with the Uphold® system during the study period. Three patients did not complete the 12-month follow-up and were excluded from the analysis, leaving 115 patients. Anatomical success at a mean follow-up of 23 months was 93 %, with a patient satisfaction rate of 95 %. Four patients (8 %) experienced de novo dyspareunia related to the mesh. The reoperation rate for mesh-related complications was 3.4 %; no patients were re-operated for POP recurrence.

Conclusions

The subjective and objective cure rates were high and the mesh-related re-operation rate was 3 % in the medium term, suggesting that this surgical technique may be an option for women requiring anterior and apical prolapse repair.
Literatur
4.
Zurück zum Zitat Altman D, Vayrynen T, Engh ME, Axelsen S, Falconer C, Nordic Transvaginal Mesh G (2011) Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med 364(19):1826–1836CrossRefPubMed Altman D, Vayrynen T, Engh ME, Axelsen S, Falconer C, Nordic Transvaginal Mesh G (2011) Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med 364(19):1826–1836CrossRefPubMed
5.
Zurück zum Zitat Brandao DR, da Silveira S, Haddad JM, de Jarmy-Di Bella ZI, Nastri F, Kawabata MG, da Silva CS, Rodrigues CA, Baracat EC, Auge AP (2014) Multicenter, randomized trial comparing native vaginal tissue repair and synthetic mesh repair for genital prolapse surgical treatment. Int Urogynecol J. doi:10.1007/s00192-014-2501-z Brandao DR, da Silveira S, Haddad JM, de Jarmy-Di Bella ZI, Nastri F, Kawabata MG, da Silva CS, Rodrigues CA, Baracat EC, Auge AP (2014) Multicenter, randomized trial comparing native vaginal tissue repair and synthetic mesh repair for genital prolapse surgical treatment. Int Urogynecol J. doi:10.​1007/​s00192-014-2501-z
6.
Zurück zum Zitat Barski D, Otto T, Gerullis H (2014) Systematic review and classification of complications after anterior, posterior, apical, and total vaginal mesh implantation for prolapse repair. Surg Technol Int 24:217–224PubMed Barski D, Otto T, Gerullis H (2014) Systematic review and classification of complications after anterior, posterior, apical, and total vaginal mesh implantation for prolapse repair. Surg Technol Int 24:217–224PubMed
8.
Zurück zum Zitat Winkler HA, Tomeszko JE, Sand PK (2000) Anterior sacrospinous vaginal vault suspension for prolapse. Obstet Gynecol 95(4):612–615CrossRefPubMed Winkler HA, Tomeszko JE, Sand PK (2000) Anterior sacrospinous vaginal vault suspension for prolapse. Obstet Gynecol 95(4):612–615CrossRefPubMed
10.
Zurück zum Zitat Amarenco G, Kerdraon J, Perrigot M (1992) Rééducation vésico-sphinctérienne et ano-rectale. Urinary symptoms evaluation scale: mesure du handicap urinaire (MHU). Springer, Heidelberg Berlin New York. pp 498–504 Amarenco G, Kerdraon J, Perrigot M (1992) Rééducation vésico-sphinctérienne et ano-rectale. Urinary symptoms evaluation scale: mesure du handicap urinaire (MHU). Springer, Heidelberg Berlin New York. pp 498–504
11.
Zurück zum Zitat Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17CrossRefPubMed Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17CrossRefPubMed
12.
Zurück zum Zitat Ulrich D, Rojas RG, Dietz HP, Mann K, Trutnovsky G (2013) Evaluation of VAS for bother of prolapse. Ultrasound Obstet Gynecol. doi:10.1002/uog.13222 Ulrich D, Rojas RG, Dietz HP, Mann K, Trutnovsky G (2013) Evaluation of VAS for bother of prolapse. Ultrasound Obstet Gynecol. doi:10.​1002/​uog.​13222
13.
Zurück zum Zitat De Tayrac R, Faillie JL, Gaillet S, Boileau L, Triopon G, Letouzey V (2012) Analysis of the learning curve of bilateral anterior sacrospinous ligament suspension associated with anterior mesh repair. Eur J Obstet Gynecol Reprod Biol 165(2):361–365. doi:10.1016/j.ejogrb.2012.09.004 CrossRefPubMed De Tayrac R, Faillie JL, Gaillet S, Boileau L, Triopon G, Letouzey V (2012) Analysis of the learning curve of bilateral anterior sacrospinous ligament suspension associated with anterior mesh repair. Eur J Obstet Gynecol Reprod Biol 165(2):361–365. doi:10.​1016/​j.​ejogrb.​2012.​09.​004 CrossRefPubMed
15.
Zurück zum Zitat Vu MK, Letko J, Jirschele K, Gafni-Kane A, Nguyen A, Du H, Goldberg RP (2012) Minimal mesh repair for apical and anterior prolapse: initial anatomical and subjective outcomes. Int Urogynecol J 23(12):1753–1761. doi:10.1007/s00192-012-1780-5 CrossRefPubMed Vu MK, Letko J, Jirschele K, Gafni-Kane A, Nguyen A, Du H, Goldberg RP (2012) Minimal mesh repair for apical and anterior prolapse: initial anatomical and subjective outcomes. Int Urogynecol J 23(12):1753–1761. doi:10.​1007/​s00192-012-1780-5 CrossRefPubMed
16.
Zurück zum Zitat Vollebregt A, Fischer K, Gietelink D, van der Vaart CH (2011) Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar-guided transobturator anterior mesh. BJOG 118(12):1518–1527. doi:10.1111/j.1471-0528.2011.03082.x CrossRefPubMed Vollebregt A, Fischer K, Gietelink D, van der Vaart CH (2011) Primary surgical repair of anterior vaginal prolapse: a randomised trial comparing anatomical and functional outcome between anterior colporrhaphy and trocar-guided transobturator anterior mesh. BJOG 118(12):1518–1527. doi:10.​1111/​j.​1471-0528.​2011.​03082.​x CrossRefPubMed
17.
Zurück zum Zitat De Landsheere L, Ismail S, Lucot JP, Deken V, Foidart JM, Cosson M (2012) Surgical intervention after transvaginal Prolift mesh repair: retrospective single-center study including 524 patients with 3 years’ median follow-up. Am J Obstet Gynecol 206(1):83.e1–83.e7. doi:10.1016/j.ajog.2011.07.040 CrossRef De Landsheere L, Ismail S, Lucot JP, Deken V, Foidart JM, Cosson M (2012) Surgical intervention after transvaginal Prolift mesh repair: retrospective single-center study including 524 patients with 3 years’ median follow-up. Am J Obstet Gynecol 206(1):83.e1–83.e7. doi:10.​1016/​j.​ajog.​2011.​07.​040 CrossRef
18.
Zurück zum Zitat Cayrac M, Letouzey V, Ouzaid I, Costa P, Delmas V, de Tayrac R (2012) Anterior sacrospinous ligament fixation associated with paravaginal repair using the Pinnacle device: an anatomical study. Int Urogynecol J 23(3):335–340. doi:10.1007/s00192-011-1554-5 CrossRefPubMed Cayrac M, Letouzey V, Ouzaid I, Costa P, Delmas V, de Tayrac R (2012) Anterior sacrospinous ligament fixation associated with paravaginal repair using the Pinnacle device: an anatomical study. Int Urogynecol J 23(3):335–340. doi:10.​1007/​s00192-011-1554-5 CrossRefPubMed
19.
Zurück zum Zitat De Tayrac R, Boileau L, Fara JF, Monneins F, Raini C, Costa P (2010) Bilateral anterior sacrospinous ligament suspension associated with a paravaginal repair with mesh: short-term clinical results of a pilot study. Int Urogynecol J 21(3):293–298. doi:10.1007/s00192-009-1036-1 CrossRefPubMed De Tayrac R, Boileau L, Fara JF, Monneins F, Raini C, Costa P (2010) Bilateral anterior sacrospinous ligament suspension associated with a paravaginal repair with mesh: short-term clinical results of a pilot study. Int Urogynecol J 21(3):293–298. doi:10.​1007/​s00192-009-1036-1 CrossRefPubMed
20.
Zurück zum Zitat Rusavy Z, Rivaux G, Fatton B, Cayrac M, Boileau L, de Tayrac R (2013) Voiding difficulties after vaginal mesh cystocele repair: does the perivesical dissection matter? Int Urogynecol J 24(8):1385–1390. doi:10.1007/s00192-012-2030-6 CrossRefPubMed Rusavy Z, Rivaux G, Fatton B, Cayrac M, Boileau L, de Tayrac R (2013) Voiding difficulties after vaginal mesh cystocele repair: does the perivesical dissection matter? Int Urogynecol J 24(8):1385–1390. doi:10.​1007/​s00192-012-2030-6 CrossRefPubMed
21.
Zurück zum Zitat Lo TS, Bt Karim N, Cortes EF, Wu PY, Lin YH, Tan YL (2015) Comparison between Elevate anterior/apical system and Perigee system in pelvic organ prolapse surgery: clinical and sonographic outcomes. Int Urogynecol J 26(3):391–400. doi:10.1007/s00192-014-2492-9 CrossRefPubMed Lo TS, Bt Karim N, Cortes EF, Wu PY, Lin YH, Tan YL (2015) Comparison between Elevate anterior/apical system and Perigee system in pelvic organ prolapse surgery: clinical and sonographic outcomes. Int Urogynecol J 26(3):391–400. doi:10.​1007/​s00192-014-2492-9 CrossRefPubMed
Metadaten
Titel
Utero-vaginal suspension using bilateral vaginal anterior sacrospinous fixation with mesh: intermediate results of a cohort study
verfasst von
Vincent Letouzey
Daniela Ulrich
Eva Balenbois
Arnaud Cornille
Renaud de Tayrac
Brigitte Fatton
Publikationsdatum
01.12.2015
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 12/2015
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-015-2748-z

Weitere Artikel der Ausgabe 12/2015

International Urogynecology Journal 12/2015 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.