Clinical efficacy of a trocar-guided mesh kit for repairing lateral defects.
OBJECTIVE
The optimal surgery for lateral defects is not well defined. Our objective was to assess the effects of anterior trocar-guided transvaginal mesh repair versus anterior colporrhaphy in women with lateral defects.


METHODS
This subanalysis from a randomized controlled trial of mesh kit versus anterior colporrhaphy assessed 99 patient diagnosed at baseline with lateral defects in the anterior vaginal wall. Thirty-nine patients underwent anterior colporrhaphy and 60 anterior trocar-guided transvaginal mesh surgery.


RESULTS
One year after surgery, a persistent lateral defect was significantly more common after colporrhaphy compared with transvaginal mesh [11/32 (34.4 %) vs 1/42 (2.4 %), risk ratio (RR) 14.4, 95 % confidence interval (CI) 2.0-106.1; P < 0.001)] However, there were no significant differences between treatment groups with regard to subjective symptoms as reflected by the overall Urogenital Distress Inventory scores, with mean difference from baseline 37.3 ± 50.6 in the colporrhaphy group vs 39.0 ± 45.8 in the mesh group (p = 0.61).


CONCLUSIONS
Use of a transvaginal mesh kit increases the odds for anatomical correction of lateral defects compared with anterior colporrhaphy but does not necessarily improve lower urinary tract symptoms.
Division of Obstetrics and Gynaecology, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. marion.ek@sodersjukhuset.se
Marion
M
Ek
Daniel
D
Altman
Jonas
J
Gunnarsson
Christian
C
Falconer
Gunilla
G
Tegerstedt
D000368:Aged; D003127:Colposcopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012086:Reoperation; D013525:Surgical Instruments; D013526:Surgical Mesh; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery