Related Experiment Video
Updated: May 12, 2025
Transvaginal Mesh Insertion in the Ovine Model
Published on: July 27, 2017
Narrower Mesh Arm Width Is an Independent Predictor of Prolapse Recurrence After Transvaginal Mesh Surgery Using
Kenji Kuroda1, Koetsu Hamamoto1, Kazuki Kawamura1
1Department of Urology, National Defense Medical College, Tokorozawa, JPN.
Introduction:
Transvaginal mesh surgery (TVM) is a less invasive and time-efficient surgical technique for the treatment of pelvic organ prolapse (POP). However, POP recurrence is a concern in patients treated with TVM using the ORIHIME (Kono Seisakusho, Japan, Tokyo) mesh. In this study, we investigated the influence of mesh-related factors on POP recurrence after TVM using ORIHIME.
Methods:
The study enrolled 104 patients who underwent TVM at our hospital between July 2019 and March 2024. The Pearson chi-squared test, multiple logistic regression analysis, and Cox proportional hazards model were used to identify independent predictors of prolapse recurrence.
Results:
Among preoperative and intraoperative factors, POP stage 4 and mesh arm width < 6 cm were significantly associated with prolapse recurrence (both p <0.05). On multiple logistic regression analysis, only the mesh arm width < 6 cm was a significant predictor of recurrence (p = 0.0077). Additionally, in the multivariate Cox proportional hazards model, only the mesh arm width < 6 cm was an independent predictor of shorter time to prolapse recurrence (hazard ratio, 8.39; 95% confidence interval, 1.70 - 41.35; p = 0.0089).
Conclusion:
Narrow mesh arm width can contribute to POP recurrence after TVM using ORIHIME. Applying wider mesh arms can help minimize the POP recurrence rate.
Insights
Narrower transvaginal mesh arms (less than 6 cm) are linked to higher pelvic organ prolapse recurrence after ORIHIME mesh surgery. Wider mesh arms may reduce recurrence rates in POP treatment.
Area of Science:
- Urogynecology
- Surgical Innovation
- Pelvic Floor Disorders
Background:
- Transvaginal mesh surgery (TVM) offers a minimally invasive approach for pelvic organ prolapse (POP).
- Recurrence of POP remains a challenge following TVM, particularly with specific mesh types like ORIHIME.
- Investigating mesh-related factors is crucial for improving TVM outcomes.
Purpose of the Study:
- To determine the impact of mesh characteristics on POP recurrence after TVM using ORIHIME mesh.
- To identify specific mesh-related predictors of prolapse recurrence.
Main Methods:
- Retrospective analysis of 104 patients undergoing TVM with ORIHIME mesh.
- Statistical analysis including Pearson chi-squared, logistic regression, and Cox proportional hazards models.
- Identification of preoperative and intraoperative predictors of prolapse recurrence.
Main Results:
- POP stage 4 and mesh arm width < 6 cm were associated with recurrence (p <0.05).
- Mesh arm width < 6 cm independently predicted recurrence in logistic regression (p = 0.0077).
- Narrow mesh arm width (< 6 cm) was an independent predictor of shorter time to recurrence (HR, 8.39; p = 0.0089).
Conclusions:
- A narrow mesh arm width (< 6 cm) is a significant risk factor for POP recurrence after TVM with ORIHIME mesh.
- Utilizing wider mesh arms may be a strategy to decrease POP recurrence rates.
- Optimizing mesh selection is key to enhancing long-term success in TVM for POP.
