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Total pelvic mesh repair: a ten-year experience
E S Sullivan1, C J Longaker, P Y Lee
1Colon and Rectal Clinic, Portland, Oregon 97205, USA.
Diseases of the Colon and Rectum
|June 8, 2001
Summary
Total pelvic mesh repair effectively restores pelvic floor function in women with pelvic organ prolapse. This surgical technique demonstrates a high patient satisfaction rate and no recurrence of prolapse in long-term follow-up.
Area of Science:
- Urogynecology
- Pelvic Floor Surgery
- Female Pelvic Medicine
Background:
- Pelvic organ prolapse (POP) significantly impacts women's quality of life.
- Previous surgical repairs may fail, necessitating advanced reconstructive techniques.
- Combined organ prolapse requires comprehensive treatment strategies.
Purpose of the Study:
- To describe the technique and outcomes of Total Pelvic Mesh Repair (TPMR).
- To evaluate the safety and efficacy of TPMR in treating complex POP.
- To assess long-term patient satisfaction and recurrence rates.
Main Methods:
- TPMR utilizes Marlex Mesh to reconstruct the pelvic floor, supporting vaginal, bladder, and rectal structures.
- The procedure involves securing mesh between the perineal body and sacrum, with extensions to the pubis.
- Patient selection included those with failed prior repairs or combined organ prolapse.
Main Results:
- 236 women underwent TPMR between 1990-1999; 205 were available for follow-up.
- The reoperation rate was 10%, with mesh erosion occurring in 5% of patients.
- No recurrence of rectal or vaginal prolapse was observed; long-term satisfaction ranged from 68-74%.
Conclusions:
- Total Pelvic Mesh Repair is a safe and effective surgical option for women with pelvic organ prolapse.
- The procedure offers durable support and high patient satisfaction.
- TPMR addresses complex cases of prolapse where other methods have failed.