title: Combined reconstructive surgery involving uterosacral colpopexy and anterior vaginal mesh implantation for pelvic organ prolapse.
abstract: OBJECTIVE
  The optimal treatment for pelvic organ prolapse has been the subject of much discussion. The aim of this study was to assess the utility of a combination of uterosacral colpopexy and anterior vaginal mesh implantation.
  
  
  METHODS
  A single-center prospective cohort study was conducted. Twenty-eight patients with stage III-IV cystocele and uterine prolapse underwent reconstructive surgery. A combination of vaginal hysterectomy, McCall culdeplasty, and trocar-guided anterior vaginal mesh implantation was performed, and the patients' postoperative outcomes were analyzed. Patient satisfaction was investigated using the modified Short Form 12 version 2 (SF-12v2) questionnaire, and interviews regarding sexual behavior were conducted at 1 postoperative year.
  
  
  RESULTS
  A bladder injury occurred during the dissection in one case (3.6%). Recurrent vaginal vault prolapse beyond the hymen was observed in one patient (cure rate: 96.4%), and further mesh augmentation was required in this case. Another patient developed mild cystocele (Ba = 0), but was simply observed because she did not complain of any symptoms caused by vaginal descent. We did not experience any other mesh-related complications, such as protrusion, chronic pain, or chronic inflammation, during the follow-up period. The patients' modified SF-12 scores at 12 months were significantly better than their preoperative scores in all eight domains.
  
  
  CONCLUSIONS
  The satisfactory correction of pelvic organ prolapse was achieved using a combination of vaginal hysterectomy and uterosacral ligament colpopexy augmented by anterior vaginal mesh implantation. © 2016 Japan Society of Obstetrics and Gynecology.
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Hamuro
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Tachibana
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yanai
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kurihara
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Misugi
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Katayama
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nakano
authors.affiliation: Division of Women's Life Care Medicine, Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Koyama
mesh_terms: D000368:Aged; D052858:Cystocele / Q000453:epidemiology; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D007431:Intraoperative Complications / Q000453:epidemiology; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome
keywords: McCall culdeplasty; anterior vaginal mesh; cystocele; health questionnaire; pelvic organ prolapse