Collagen-coated polypropylene mesh in vaginal prolapse surgery: an observational study.

Abstract

OBJECTIVE:

We evaluated the efficacy and safety of a collagen-coated polypropylene mesh with a trans-obturator approach for cystocele repair.

STUDY DESIGN:

We considered as eligible for our study 97 patients with a stage ≥ 2 cystocele according to the Pelvic Organ Prolapse Staging System (POP-Q), with or without associated apical or posterior vaginal wall prolapse. They were also evaluated pre- and post-operatively using validated questionnaires (P-QoL, Wexner and PISQ-12). Patients underwent cystocele repair using Avaulta Biosynthetic Anterior Support System (CR Bard Inc., Billerica, USA). Objective anatomical cure was defined when points Ba, C and Bp were at stage 0 (good outcome) or stage 1 (satisfactory outcome). The McNemar chi-square test was used to compare categorical variables, the paired t-test for continuous parametric variables, and the Mann-Whitney test for continuous non-parametric variables.

RESULTS:

All patients completed the 1-year follow-up. We observed an anatomical cure rate of 64.9% for anterior vaginal wall prolapse (point Ba<-1), and a statistically significant improvement in storage, voiding, post-micturition and prolapse-related symptoms. Quality of Life and sexuality were also statistically improved, while we found no impact on anorectal function. We also observed the development of vaginal mesh exposure in 21 patients (21.6%).

CONCLUSION:

Our data suggest that the collagen-coated polypropylene mesh, as we used it, gives a high recurrence rate (35.1%) and a high exposure rate (21.6%) at one-year follow-up, and is consequently unsatisfactory for the treatment of anterior vaginal wall prolapse.

• Authors: Mauro Cervigni, Franca Natale, Chiara La Penna, Maria Saltari, Anna Padoa, Massimo Agostini
• Journal: European journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 156 Issue 2 Pg. 223-7 (Jun 2011) ISSN: 1872-7654 [Electronic] Ireland
• PMID: 21367513 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Coated Materials, Biocompatible
• Polypropylenes
• Collagen

Topics

• Adult
• Aged
• Aged, 80 and over
• Coated Materials, Biocompatible
• Collagen
• Cystocele (surgery)
• Female
• Gynecologic Surgical Procedures
• Humans
• Middle Aged
• Polypropylenes
• Prosthesis Implantation
• Suburethral Slings
• Surgical Mesh
• Treatment Outcome