[Treatment of genital prolapse with a polypropylene mesh inserted via the vaginal route. Anatomic and functional outcome in women aged less than 50 years].
OBJECTIVE
We evaluated the results of surgical insertion of a polypropylene mesh via the vaginal route in young women presenting genital prolapse.


METHODS
Retrospective study concerning 20 women under age 50 who underwent between July 2000 and December 2003 surgical insertion of an anterior (n=14), posterior (n=3) or double (anterior and posterior) (n=3) polypropylene mesh via the vaginal route. A minimum follow-up of 6 months was required for inclusion in the study. Anatomical results were assessed using the Pelvic Organ Prolapse Quantification (POP-Q) according to ICS (International Continence Society) recommendations. To document the functional results, the patients answered 3 validated self-assessment questionnaires related to pelvic symptoms, sexual behaviors and quality of life.


RESULTS
Mean follow-up was 21 months (6 to 52 months). A vaginal erosion of the mesh occurred in 2 women (10%). Cystocele recurred in one woman among the 17 patients who had an anterior polypropylene mesh (Gynemesh, Gynecare, Ethicon). Seventeen women were sexually active before the surgical procedure and 19 post-operatively. Among these women, 5 (26%) reported alteration of sexual activity after surgery (with dyspareunia in 4 cases (21%)), and 14 women (74%) reported no changes or improvement in sexual activity.


CONCLUSIONS
Surgical management of genital prolapse using a polypropylene mesh inserted via the vaginal route has proven its anatomical efficacy in young women. The potential adverse consequences on sexual life would require clinical research concerning the surgical approach (abdominal or vaginal route) and synthetic materials used in prolapse surgery for young women.
Benhaim
Y
Y
Service de Gynécologie Obstétrique, Hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92140 Clamart.
de Tayrac
R
R
Deffieux
X
X
Gervaise
A
A
Chauveaud-Lambling
A
A
Frydman
R
R
Fernandez
H
H
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011126:Polypropylenes; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000502:physiology* / Q000523:psychology; D013526:Surgical Mesh / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000453:epidemiology; D014596:Uterine Prolapse / Q000601:surgery*
D011126:Polypropylenes