title: Cystocele repair by a synthetic vaginal mesh secured anteriorly through the obturator foramen.
abstract: OBJECTIVE
  Our aim was to assess the feasibility and short-term results of cystocele repair by the placement of a synthetic subvesical mesh secured anteriorly through the obturator foramen.
  
  
  METHODS
  Between 1 November 2001 and 31 July 2002, 30 consecutive patients with a grade 2 (n = 18, 60%) or 3 (n =12, 40%) cystocele were prospectively included in the study.
  
  
  RESULTS
  The obturator route was feasible in all cases. No intraoperative complications arose. After a mean follow-up of 6.7 months (range: 2-12), 90% (n = 27) of the patients were cystocele grade 0, 7% (n = 2) grade 1 and failure was observed in a young patient (3%) treated without hysterectomy. Two vaginal erosions (7%) were observed at six and nine months. For the 14 patients (47%) who had sexual relations after surgery, 2 (14%) complained of anterior dyspareunia.
  
  
  CONCLUSIONS
  The obturator approach is a simple and sure technique for placing a polypropylene synthetic subvesical mesh. The long term stability and tolerance of the results must be confirmed.
authors.affiliation: Department of Obstetrics and Gynecology, Hôpital Bichat, 46 Rue Henri Huchard, 75018 Paris, France. yan.ansquer@lmr.ap-hop-paris.fr
authors.forename: Ansquer
authors.initials: A
authors.lastname: Yan
authors.forename: Marcollet
authors.initials: M
authors.lastname: Anne
authors.forename: Alves
authors.initials: A
authors.lastname: Karine
authors.forename: Fain
authors.initials: F
authors.lastname: Vanessa
authors.forename: Poncelet
authors.initials: P
authors.lastname: Christophe
authors.forename: Thoury
authors.initials: T
authors.lastname: Anne
authors.forename: Madelenat
authors.initials: M
authors.lastname: Patrick
mesh_terms: D000328:Adult; D000368:Aged; D004414:Dyspareunia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D013526:Surgical Mesh; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000601:surgery; D016055:Urinary Retention / Q000453:epidemiology; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D014621:Vagina; D014623:Vaginal Diseases / Q000453:epidemiology / Q000601:surgery