title: Cystocele repair by vaginal route: comparison of three different surgical techniques of mesh placement.
abstract: OBJECTIVE
  Different techniques of mesh placement for cystocele repair are known. Our goal was to compare anatomical and functional outcomes of three different techniques of mesh placement over a 3-year follow-up.
  
  
  METHODS
  Between March 2003 and June 2004, 230 patients (stage 2-4 pelvic organ prolapse (POP)) were included in a prospective study. For cystocele repair, mesh was implanted either with two arms into the retropubic space (RP) or with two to four arms into the obturator foramen (TO), or fixed to the arcus tendineous fascia pelvis (FG).
  
  
  RESULTS
  Patients' distribution is as follows: 142 TO, 32 RP, and 31 FG. Anatomical success (cystocele < stage 2 in the POP staging system) was clearly poorer after the retropubic free technique, with success rates of 69% (RP), 90.1% (TO), and 96.6% (FG) (p = 0.004). POP distress inventory (p < 0.005) and POP impact questionnaire scores were both significantly poorer after RP.
  
  
  CONCLUSIONS
  RP technique is less effective than TO and FG techniques.
authors.affiliation: Department of Obstetrics and Gynaecology, Bocage University Hospital, Dijon, France. donmourtialone@yahoo.fr
authors.forename: Pascal
authors.initials: P
authors.lastname: Mourtialon
authors.forename: Vincent
authors.initials: V
authors.lastname: Letouzey
authors.forename: Georges
authors.initials: G
authors.lastname: Eglin
authors.forename: Renaud
authors.initials: R
authors.lastname: de Tayrac
mesh_terms: D000368:Aged; D020099:Coated Materials, Biocompatible; D052858:Cystocele / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000175:diagnosis / Q000523:psychology / Q000601:surgery; D011126:Polypropylenes; D011446:Prospective Studies; D011788:Quality of Life; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods*; D014621:Vagina
chemical_list: D020099:Coated Materials, Biocompatible; D011126:Polypropylenes