Transobturator tension-free mesh for female anterior pelvic floor reconstruction / 上海第二医科大学学报

ABSTRACT

Objective To investigate the efficacy and safety of anterior pelvic floor reconstruction with transobturator tension-free vaginal mesh in the treatment of moderate to severe or recurrent anterior vaginal wall prolapse. MethodsAnterior pelvic floor reconstruction with transobturator tension-free vaginal polypropylene mesh were performed on 36 women with stage 3 to stage 4 or recurrent anterior vaginal wall prolapse.Those with stress urinary incontinence(SUI) or potential SUI were also treated with transobturator inside-out tension-free vaginal tape(TOT).The surgical efficacy was determined by comparison of POP-Q classification system pre-and post-operation.Complications of the procedure were statistically analyzed. Results The mean time of operation for anterior pelvic floor reconstruction with transobturator tension-free vaginal polypropylene mesh was 52 min,mean intraoperative blood loss was 55 mL,and mean hospital stay was 3.5 d.No operative complications occurred.All the anterior vaginal wall prolapse was corrected.No recurrence was observed after the follow up for 2 to 24 months,with the effective rate of 100%.The grade of urinary incontinence was improved remarkably,with the effective rate of 100%.The erosion after the procedure with vaginal polypropylene mesh happened in 2 cases,with the incidence of 5.56%. Conclusion Anterior pelvic floor reconstruction with transobturator tension-free vaginal polypropylene mesh is a minimally-invasive procedure for the treatment of moderate to severe or recurrent anterior vaginal wall prolapse.TOT should also be performed for those with SUI or potential SUI.Though erosion of mesh may take place post-operation,this procedure is safe and has a favourable short-term effect.The long-term effect leaves for further investigations.