Suburethral slingplasty using a self-fashioned Gynemesh for treating urinary incontinence and anterior vaginal wall prolapse.
OBJECTIVE
This study was conducted to evaluate the effectiveness of self-fashioned Gynemesh for the concomitant treatment of urinary incontinence and anterior vaginal wall prolapse, and the factors involved in mesh erosion.


METHODS
From March 2004 to September 2006, 65 women with urinary incontinence, with or without pelvic organ prolapse or prior surgery for prolapse or incontinence, were recruited for this study. A self-fashioned Gynemesh was used for the concomitant treatment of urinary incontinence and anterior vaginal wall prolapse. Patients in this study underwent suburethral slingplasty and/or concomitant pelvic reconstructive operations. A general linear model univariate analysis was performed to assess the relationships between mesh erosion and various variables.


RESULTS
The mean postoperative follow-up was 33 months. Those patients with anterior wall prolapse presented as completely cured postoperatively. The cure rate for urinary incontinence was 80%, and the improvement rate was 17%. Vaginal mesh erosion was discovered in four patients (6%) during the postoperative follow-up. These four patients remained continent after the removal of the eroded mesh. The interactive effects for mesh erosion by a general linear model analysis were menopausal women with advanced anterior vaginal wall prolapse (p < 0.05) and women with advanced anterior vaginal wall prolapse with concomitant sacrospinous ligament fixation (p < 0.05).


CONCLUSIONS
We found that using self-fashioned Gynemesh for tension-free suburethral and anterior vaginal slingplasty provided a high success rate (97%) in the 3 years of follow-up. Mechanical rejection may be one of the causes of vaginal mesh erosion.
Su
Chi-Feng
CF
Department of Obstetrics and Gynecology, Kuang Tien General Hospital, Taichung, Taiwan.
Ng
Soo-Cheen
SC
Tsui
Kwong-Pang
KP
Chen
Gin-Den
GD
Tsai
Horng-Jyh
HJ
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh / Q000009:adverse effects; D014549:Urinary Incontinence / Q000150:complications / Q000601:surgery*; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*
D001672:Biocompatible Materials