To evaluate the medium-term efficacy and safety of transobturator four-arm polypropylene mesh in the treatment of high-stage anterior vaginal wall prolapse and concomitant stress urinary incontinence (SUI).
Between September 2010 and August 2013, a prospective single-center trial was performed to evaluate women with stage≥3 anterior vaginal wall prolapse with or without SUI who presented to Labbafinejad Hospital, Teheran, Iran, and underwent anterior vaginal wall repair with polypropylene mesh. Pre- and postoperative evaluation included history; physical examination using the Pelvic Organ Prolapse Quantification system and cough stress test, both before and after reduction of prolapsed structures; Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ); urinalysis and culture; and a postvoid residual assessment. Complications were reported at a mean of 2 years of follow-up.
A total of 71 patients underwent cystocele repair with the transobturator four-arm polypropylene mesh. Seven of the patients were lost to follow-up. There were no perioperative complications. The anatomical success rate was 87. 5%. The subjective success rate was 92. 1%. The PFDI and PFIQ were significantly improved after surgery (p<0. 001). Among those with the simultaneous complaint of SUI, 82% were cured without any additional procedure. Three patients (4. 6%) experienced vaginal mesh extrusion. Two patients (3. 1%) reported worsening of dyspareunia after surgery.
The four arms polypropylene mesh is an effective device for simultaneous correction of anterior vaginal wall prolapse and SUI with a low complication rate at a medium-term follow-up. The majority of the subgroup with concomitant SUI were cured without a second simultaneous procedure.
Korean journal of urology. 2015 Dec 10 [Epub]
Farzaneh Sharifiaghdas, Azar Daneshpajooh, Mahboubeh Mirzaei
Urology-Nephrology Research Center, Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. , Kerman University of Medical Sciences, Kerman, Iran. , Kerman University of Medical Sciences, Kerman, Iran.