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Transvaginal repair of genital prolapse with polypropylene mesh using a tension-free technique
Rajka B Argirovic1, Aleksandra M Gudovic, Ivana R Babovic
1Department of Postoperative Care, Institute for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia.
Objectives:
To assess the perioperative complications and short-term outcomes of prolapse repair using transvaginal polypropylene mesh.
Study Design:
Retrospective study. In the period from April 2007 to September 2009, 67 women underwent vaginal repair with implantation of a soft mesh manufactured by Gynecare.
Results:
All the patients had a stage 3 or stage 4 prolapse. Total mesh was used in eight patients (11.9%), isolated anterior mesh in 36 patients (53.7%) and isolated posterior mesh in 23 patients (34.4%). We reported one intraoperative bladder injury and no other serious complications. At 3 months, all the 67 patients were available for follow-up. Vaginal erosion occurred in eight patients (11.9%), shrinkage of mesh in six patients (8.7%), granuloma without exposure in four patients (5.9%), de novo urinary incontinence in three patients (4.5%) and flatus incontinence in one patient (1.5%). Failure rate was 7.5% (recurrent prolapse stage 3 or 4, even asymptomatic).
Conclusion:
Our study suggests that transvaginal polypropylene mesh applied with a tension-free technique is a safe and effective method with low intraoperative complications but with considerable potential postoperative morbidity.
