title: Simultaneous correction of anterior and apical vaginal prolapse with the modified placement of the transobturator-guided mesh (Anterior Prolift™) set.
abstract: OBJECTIVE
  Modified placement of the Anterior Prolift™ (MODAP) in patients with prolapse of the anterior and middle vaginal compartment is described. It was performed in order to achieve simultaneous tension-free correction of the anterior and middle vaginal compartment without excessive use of the mesh.
  
  
  METHODS
  MODAP was performed in 32 patients. The anterior part of the mesh was placed transobturatorily. Surplus of the central part of the mesh was longitudinally divided and fixed around the cervix. Posterior mesh arms were passed through the sacrospinous ligament. All patients were analyzed regarding anatomy and symptoms 1 year after surgery.
  
  
  RESULTS
  Cure of pelvic organ prolapse was achieved in 28 of 32 (87.5%) patients. The position of Ba and C points was significantly corrected (p = 0.00). Deterioration of the posterior compartment occurred in 1 case. Symptoms of pelvic organ prolapse were significantly corrected (p = 0.05 up to p = 0.00) except for rectal emptying.
  
  
  CONCLUSIONS
  MODAP makes an improvement of both anatomy support and symptoms in cases with mixed insufficiency of the anterior vaginal wall and apical vaginal support.
authors.affiliation: Clinic of Urology, Clinical Center Niš, Niš, Serbia. ivanig @ live.com
authors.forename: Ivan
authors.initials: I
authors.lastname: Ignjatovic
authors.forename: Ivica
authors.initials: I
authors.lastname: Stojkovic
authors.forename: Jablan
authors.initials: J
authors.lastname: Stankovic
authors.forename: Dragoslav
authors.initials: D
authors.lastname: Basic
authors.forename: Milan
authors.initials: M
authors.lastname: Potic
authors.forename: Biserka
authors.initials: B
authors.lastname: Ignjatovic
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D013513:Obstetric Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D011446:Prospective Studies; D011474:Prosthesis Design; D055771:Serbia; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*