Efficacy and Safety of Cystocele Repair Reinforced with a Monofilament Polypropylene Mesh / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Although surgical options for a cystocele repair have changed diversely over the past twenty years, a 29% recurrence rate after an operation has been reported. We assessed the efficacy and safety of a cystocele repair using monofilament polypropylene mesh (MPM) to reinforce the weakened muscular pelvic floor. MATERIALS AND METHODS: 28 women underwent a cystocele repair using MPM. According to the International Continence Society (ICS) stage classification, 5, 20 and 3 women had stages II, III and IV cystocele, respectively. The operations were performed through the vaginal approach. An anterior colporrhaphy was performed, and mesh (15x5cm), with the lateral extensions, was then positioned into the retropubic space, without fixation, for tension free support of the bladder. The cure of cystocele was defined as stage 0, improvement as stage I, and failed treatment as stage II or greater. RESULTS: The mean follow-up, catheterization time and hospital stay were 20.4+/-3.2 months, 2.4+/-1.2 days and 6.6+/-3.4 days, respectively. The anatomical cure rate of cystocele was 89.3% (25/28). The cystocele repair improved 2 patients, but failed in 1. No significant intraoperative complications occurred. The postoperative complications included voiding difficulty (2 cases), vaginal bleeding around the suture site (1 case) and de novo urgency (2 cases). There were no mesh related complications. CONCLUSIONS: Cystocele repair using MPM showed a success rate of 89.3%, with no complications associated with the use of mesh. This procedure seems to be safe and efficient, but a prospective randomized trial and longer follow-up will be required to confirm these results.