Combined anterior trans-obturator mesh and sacrospinous ligament fixation in women with severe prolapse--a case series of 30 months follow-up.
OBJECTIVE
To study the efficacy and safety of performing anterior mesh (Perigee) with vaginal reconstructive surgeries (sacrospinous ligament fixation) for treatment of advanced prolapse.


METHODS
One hundred twenty-eight patients, POP-Q stage III (n = 85) or IV (n = 43), underwent surgery. The objective cure was defined as less than stage 2 prolapse. Introital ultrasonography was used for mesh morphological evaluation.


RESULTS
Post-operative data were available for 120 patients. At 30 months, the objective cure was 91.8%. The subjective cure was 93.3% on POPDI-6 feedback. No apical and anterior recurrence was observed. Surgical complications were minor. Five cases (4.1%) of mesh extrusion was observed. Mesh shortening, shrinkage, and thickening was also observed.


CONCLUSIONS
The combination of anterior vaginal mesh and vaginal reconstructive surgery appears to be a safe and effective in restoring the anatomy and achieving favorable pelvic function. The anterior mesh deployed seems to cover a lesser area than anticipated. A longer period of follow-up is necessary to confirm its efficacy.
Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan. 2378@cgmh.org.tw
Tsia-Shu
TS
Lo
Kiran
K
Ashok
D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013526:Surgical Mesh; D016896:Treatment Outcome; D014463:Ultrasonography; D014521:Urethra / Q000601:surgery*; D014621:Vagina / Q000601:surgery*