Collagen-coated polypropylene mesh in vaginal prolapse surgery: an observational study

Area of Science:

• Urogynecology
• Pelvic reconstructive surgery
• Biomaterials in medicine

Background:

• Cystocele repair often involves surgical mesh to restore pelvic anatomy.
• Trans-obturator approaches are utilized for anterior vaginal wall prolapse surgery.
• Evaluating the long-term efficacy and safety of surgical meshes is crucial for patient outcomes.

Purpose of the Study:

• To assess the efficacy and safety of a collagen-coated polypropylene mesh for cystocele repair using a trans-obturator approach.
• To evaluate anatomical cure rates, symptom improvement, and complication rates at one-year follow-up.

Main Methods:

• A prospective study included 97 patients with stage ≥ 2 cystocele (Pelvic Organ Prolapse Staging System - POP-Q).
• Patients underwent cystocele repair with the Avaulta Biosynthetic Anterior Support System.
• Pre- and post-operative outcomes were assessed using validated questionnaires (P-QoL, Wexner, PISQ-12), with anatomical cure defined by POP-Q staging.

Main Results:

• Anatomical cure rate for anterior vaginal wall prolapse was 64.9% at one year.
• Significant improvements were noted in storage, voiding, post-micturition, and prolapse-related symptoms, as well as Quality of Life and sexual function.
• A notable complication was vaginal mesh exposure in 21.6% of patients.

Conclusions:

• The collagen-coated polypropylene mesh demonstrated a high recurrence rate (35.1%) and a high rate of vaginal mesh exposure (21.6%) at one-year follow-up.
• These findings suggest that this specific mesh and approach are unsatisfactory for treating anterior vaginal wall prolapse.
• Further research into alternative mesh materials and surgical techniques is warranted.