ABSTRACT
OBJECTIVE: To assess at 6 months the efficiency, the safety and the satisfaction of a lightweight polypropylene mesh used for the transvaginal repair of cystocele by bilateral anterior sacrospinous ligament fixation (NUVIA™ SI). MATERIEL AND METHODS: A prospective cohort study was performed from January 2014 to June 2015. Preoperative assessment included an evaluation using the Pelvic Organ Prolapse Quantification system (POP-Q) and 3 questionnaires about symptoms, quality of life and quality of sex life (PFDI-20, PFIQ7, PISQ-12). Results were evaluated by a composite criteria: Ba≤0, absence of bulge sensation and absence of reoperation for cystocele recurrence. Secondary objectives were to assess the complications rates and patient's satisfaction. RESULTS: In 10 months, 16 patients, with a mean age of 61.9±8.8years, were included and evaluated by an independent observator at 6months. Four patients were sexually active before surgery and 5 at 6 months. Results were optimal in 93.75% cases (15/16) with one intraoperative injury (bladder injury) and one postoperative complication (increase of preoperative dyspareunia). Satisfaction rate was 93.75% (15/16) and questionnaires PFDI-20 and PFIQ-7 were statistically improved (P<0.0001 and P=0.0013). Three patients had a reintervention but not about anterior wall prolapse (section of a suburethral sling for urinary retention, suburethral sling exposure and cure of stress urinary incontinence). CONCLUSION: At short term, transvaginal mesh repair by anterior sacrospinous ligament fixation with NUVIA™ presents 93.75% optimal result with one case of increased dyspareunia and 3 reoperations which don't concern anterior wall (urinary outcomes). LEVEL OF EVIDENCE: 4.
