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A new operation for genitourinary prolapse

G Nicita1

  • 1Clinica Urologica II, Universita' degli Studi di Firenze, Florence, Italy.

The Journal of Urology
|August 28, 1998
PubMed
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A new transvaginal mesh technique effectively treats pelvic organ prolapse and incontinence. This hammock-shaped mesh offers a promising surgical solution with high patient satisfaction and no adverse effects observed in follow-up studies.

Area of Science:

  • Urogynecology
  • Pelvic reconstructive surgery

Background:

  • Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) significantly impact women's quality of life.
  • Traditional surgical methods for POP and SUI have varying success rates and complication profiles.

Purpose of the Study:

  • To introduce and evaluate a novel transvaginal surgical technique for supporting prolapsed pelvic organs using a large, hammock-shaped nonabsorbable mesh.
  • To assess the efficacy and safety of this new mesh anchoring method for treating POP and SUI.

Main Methods:

  • A transvaginal approach utilizing a custom-cut, nonabsorbable mesh shaped like a hammock.
  • Mesh anchored transversally between the arcus tendineus of the endopelvic fascia and anteroposteriorly between the bladder and uterine necks.
  • Technique applied to 44 patients (age 43-86) with POP (cystocele, uterine prolapse, vaginal vault prolapse, rectocele, enterocele) and/or SUI between January 1996 and June 1997.

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  • Preoperative assessment included cystography, video urodynamics, and pelvic/abdominal echography.

    • Main Results:

    • Complete cure of incontinence in all affected patients.
    • High satisfaction rates among patients with prolapse but without incontinence.
    • Excellent cystographic evidence of pelvic organ support restoration.
    • No significant changes in sexual function or menses; no pelvic fibrosis or hydroureteronephrosis observed.
    • Partial recurrence of third-degree uterine prolapse in 3 out of 6 cases.

    Conclusions:

    • The described transvaginal mesh technique is a simple and broadly applicable surgical option for pelvic organ prolapse and incontinence.
    • The novel mesh anchoring and size contribute to successful outcomes.
    • Longer-term follow-up is warranted to definitively establish the long-term efficacy and durability of this procedure.