title: Minimally invasive cystocele repair technique using a polypropylene mesh introduced with the transobturator route.
abstract: OBJECTIVE
  Evaluation of the safety and efficacy of the use of polypropylene mesh for cystocele repair using minimally invasive technique.
  
  
  METHODS
  We retrospectively evaluated the perioperative events, short-term postoperative side-effects, and follow up for 152 patients who underwent repair for cystocele grade 2 or more using a polypropylene mesh. The repair was performed through a small anterior vaginal wall incision, with the arms of the mesh passed through a transobturator route using a corkscrew needle. Stress urinary incontinence (SUI) tests and the International Continence Society Pelvic Organ Prolapse Quantification (POP-Q) staging systems were documented before and after surgery.
  
  
  RESULTS
  The average time and blood loss for the procedure were 18 min and 100 cc, respectively. Bladder injury and excess bleeding (>500 cc) occurred in one and two cases during the procedure, respectively. The early postoperative complications included pain (10.5 %), mesh erosion (1.3 %), fever (1.3 %), and urinary tract infection (7.9 %). Among the 122 patients who were followed up (median follow-up time, 18.2 months), the subjective and objective cure rates for the prolapse were 98 and 95 %, respectively. Complications during the follow up included mesh erosion (four cases) and persistent dyspareunia (four cases).
  
  
  CONCLUSIONS
  Cystocele repair with mesh placement through transobturator route can be considered a minimally invasive, promising method for the correction of cystocele and SUI based on the low rate of complications, the high rate of success, and the low incidence of recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Al Waili, Cairo Governorate, Cairo, 11762, Egypt.
authors.forename: Hazem
authors.initials: H
authors.lastname: Samour
authors.forename: Amgad
authors.initials: A
authors.lastname: Abougamra
authors.forename: Haitam A M
authors.initials: HA
authors.lastname: Sabaa
mesh_terms: D020884:Colpotomy; D052858:Cystocele / Q000601:surgery*; D004414:Dyspareunia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011126:Polypropylenes / Q000737:chemistry; D011183:Postoperative Complications / Q000453:epidemiology*; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D001745:Urinary Bladder Diseases / Q000453:epidemiology; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014621:Vagina / Q000601:surgery
chemical_list: D011126:Polypropylenes