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Vaginal mesh hysteropexy: a review
Angela DiCarlo-Meacham1, Donna Mazloomdoost2
1Walter Reed National Military Medical Center.
Current Opinion in Obstetrics & Gynecology
|November 8, 2021
Summary
Vaginal mesh hysteropexy offers a well-tolerated surgical option for uterovaginal prolapse, showing promising short-term results. While mesh kits aren't widely available, it's a viable treatment for select patients.
Area of Science:
- Urogynecology
- Pelvic reconstructive surgery
Background:
- Pelvic organ prolapse surgery utilizes native tissue or graft augmentation.
- Synthetic mesh grafts were developed to enhance long-term surgical outcomes.
- Vaginal hysteropexy is gaining popularity for its efficacy and improved morbidity compared to hysterectomy.
Purpose of the Study:
- To evaluate the efficacy and safety of mesh augmentation in vaginal hysteropexy.
- To address the lack of long-term outcome data for vaginal hysteropexy.
- To minimize complications associated with vaginal hysteropexy.
Main Methods:
- Review of recent studies comparing vaginal mesh hysteropexy with vaginal hysterectomy.
- Analysis of short-term follow-up data for vaginal mesh hysteropexy.
- Assessment of mesh exposure rates.
Main Results:
- Vaginal mesh hysteropexy demonstrated superiority over vaginal hysterectomy with native tissue vault suspension.
- Short-term outcomes show reduced blood loss, shorter operative times, and improved vaginal length with mesh hysteropexy.
- Low mesh exposure rates were observed, comparable to abdominal mesh procedures.
Conclusions:
- Vaginal mesh hysteropexy is a well-tolerated and effective treatment for uterovaginal prolapse.
- Despite the unavailability of commercial mesh kits, it presents a viable option for select patients.
- Further research is needed to establish long-term outcomes.
