Treating anterior vaginal wall prolapse with polypropylene mesh via the transoburator route minimizing the complications with the use of preventing measures. A prospective study with 2 year follow up - Abstract

AIM: Our objectives were to evaluate the efficacy of the PerigeeTM transoburator (TOT) mesh kit [American Medical Systems (AMS)-Minnetonka, MN, USA] in the treatment of ≥ stage 2 symptomatic AVP following a 2-year follow up and to discuss the role of the pre-, peri- and postoperative measures taken to prevent complications.

METHODS: A total of 50 patients were eligible and were subjected to AVP surgical treatment with the use of the PerigeeTM system. All patients were followed-up at 4 weeks, 2, 6, 12 and 24 months. Our primary objective was treatment success and efficacy after anatomical examination of the patient at the 24- month follow-up. Efficacy was defined as ≤ stage I AVP. All patients completed the 24-month follow-up. Our secondary objective was to examine the complication rates in relation to the use of preventative measures.

RESULTS: The proportion of patients with II to III stage significantly decreased postoperatively (p< 0.001). A significantly improvement was found in all POP-Q measures (p< 0.05) while mean vaginal length was similar to the preoperative values. At 24-month follow up, 45 women were defined as ≤stage I, indicating a 90% objective success rate (95% CI: 81.4% - 98.6%).

CONCLUSIONS: The treatment of AVP with the use of Perigee TOT system can be both effective and safe. It is crucial for POP procedures to be performed by high-volume surgeons in this field, with extensive knowledge of the pelvic floor anatomy and the mesh's characteristics.

Written by:
Adamakis I, Katafigiotis I, Tyritzis SI, Sfoungaristos S, Katafigioti A, Mygdalis V, Mitropoulos D, Constantinides CA.   Are you the author?
Department of Urology, Athens Univeristy Medical School-LAIKO Hospital Athens, Greece; Department of Urology, Patras University Medical School, Patras, Greece.  

Reference: Minerva Ginecol. 2015 Feb 10. Epub ahead of print.

PubMed Abstract
PMID: 25668420 Trauma & Reconstruction Section

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