Tension-free cystocele repair: an analysis after a follow-up of 24 months.

Abstract

AIM:

The aim of the study is to verify whether tension free cystocele repair is really a good choice for the correction of moderate or severe cystocele. The surgical approach is transvaginal and involves the use of nonabsorbable prolene mesh.

METHODS:

We enrolled 177 women with a combined genital prolapse, characterized by second degree cystocele, first degree hysterocele and first degree rectocele or more severe conditions. All the patients underwent a complete urologic and gynecologic work-up before the surgical treatment consisting in a Y-shaped mesh placed on the prevesical fascia. This technique was implemented providing a tension free prosthesis.

RESULTS:

Our results on a total of 169 patients after a follow-up of 24 months are the following: 19 patients (11%) reported a recurrent cystocele (grade II) of which 9 patients at 6 months follow-up presented a vaginal wall erosion that determined a surgical explantation of the mesh; 2 patients (1%) showed a persistent dyspareunia and were treated with estrogen therapy that gave an improvement of the symptomatology although it did not disappear; 10 (6%) patients, among the women treated only for cystocele repair (cystocele III ), complained of stress urinary incontinence of 1st degree; and, finally, 150 patients (89%) didn't report any recurrence of cystocele.

CONCLUSION:

Given the good results obtained after a follow-up of 24 months (89% of the cure rate), we can consider this procedure simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance. It is a promising approach in the management of pelvic floor dysfunctions that induces minimal foreign body reaction.

• Authors: R Granese, B Adile
• Journal: Minerva ginecologica (Minerva Ginecol) Vol. 59 Issue 4 Pg. 369-76 (Aug 2007) ISSN: 0026-4784 [Print] Italy
• PMID: 17923828 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Polypropylenes

Topics

• Adult
• Aged
• Cystocele (complications, surgery)
• Female
• Follow-Up Studies
• Gynecologic Surgical Procedures (methods)
• Humans
• Middle Aged
• Polypropylenes
• Rectocele (surgery)
• Recurrence
• Surgical Mesh
• Treatment Outcome
• Urinary Incontinence, Stress (etiology)
• Urologic Surgical Procedures (methods)
• Uterine Prolapse (surgery)