There are two goals for treatment if
vaginal prolapse, restauration of normal function and anatomy and prevention of recurrence. Most operations described for replacement and maintenance of prolapsed organs in the pelvic cavity do not treat the cause of the
prolapse which is diastasis of levator muscles and, in most cases, failure of the pelvic fascia. By analogy with the treatment of parietal
hernias, the concept of a synthetic graft to reinforce failing fascias and restauration of normal anatomy has been proposed. From June 1994 through March 1999, 46 patients were treated for genital
prolapse by a vaginal approach with positioning of a
polyester mesh sutured to the vaginal angles. No major complication was observed. One mesh exposure occurred 4 months
after treatment of a
cystocele with
vaginal hysterectomy and was treated by partial resection with good outcome. With a 5-year follow-up (median 26 months), all patients are totally satisfied. No recurrence of
prolapse was observed. Sexual function was preserved without
dyspareunia. This study demonstrates the feasability and efficacy of using a synthetic graft in the cure via a vaginal approach of genital
prolapse. Complementary studies are necessary to evaluate the indications for which the procedure can be proposed and how it should be integrated in to schemes with other procedures.