Anterior transobturator polypropylene mesh in the correction of cystocele: 2-point method vs 4-point method.
OBJECTIVE
To compare the effectiveness and safety of 2 anterior transobturator mesh methods for treating anterior vaginal wall prolapse.


METHODS
Randomized controlled study (Canadian Task Force classification I).


METHODS
University hospital.


METHODS
Eighty-seven women with anterior vaginal wall prolapse stage ≥2 (Pelvic Organ Prolapse Quantification [POP-Q]) underwent an anterior transobturator mesh procedure using macropore polypropylene mesh.


METHODS
Forty-five patients underwent the operation via the conventional 4-point, full-sized mesh method, and 42 patients underwent the operation via a novel 2-point, half-sized mesh method.


RESULTS
Patient characteristics were comparable between the 2 groups. The anatomic cure rate was significantly lower in the 2-point group compared with the 4-point group at 12 months after surgery (87.2% vs 100%; p = .03). Healing abnormalities were significantly higher in the 2-point group than in the 4-point group (12.8% vs 0%; p = .03). Bladder perforation (2.6% vs 0%), stress urinary incontinence (23.1% vs 22.5%), urinary frequency (12.8% vs 22.5%), and voiding difficulty and dyspareunia (0% vs 0%) were not statistically different between the 2 groups. At linear regression analysis, mean (SD) operation time did not differ between the 2 groups (74.9 [32.7] minutes vs 87.8 [36.7] minutes; p = .11).


CONCLUSIONS
Compared with the 4-point method, the 2-point anterior transobturator mesh method resulted in a lower rate of anatomic cure and a higher rate of healing abnormality.
Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
Jin-Sung
JS
Yuk
Chan Hee
CH
Jin
Kyong Wook
KW
Yi
Tak
T
Kim
Jun-Young
JY
Hur
Jung-Ho
JH
Shin
D000368:Aged; D052858:Cystocele / Q000601:surgery*; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D061646:Operative Time; D011126:Polypropylenes / Q000009:adverse effects; D053825:Suburethral Slings / Q000009:adverse effects; D013526:Surgical Mesh / Q000009:adverse effects; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000293:injuries; D014550:Urinary Incontinence, Stress / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology
D011126:Polypropylenes