腹腔鏡下仙骨腟固定術におけるORIHIMEメッシュとGynemesh PSの同等の成績：後向き比較研究

In Japan, laparoscopic sacrocolpopexy (LSC) is performed using either the commonly used polypropylene (PP) mesh or the domestically produced polytetrafluoroethylene (PTFE) mesh, ORIHIME. Despite its clinical adoption, the comparable performance of this material relative to conventional options such as PP mesh has not been sufficiently investigated. This study aimed to compare clinical outcomes of LSC using PTFE mesh (ORIHIME) versus PP mesh (Gynemesh PS) through a retrospective study.

A total of 211 patients who underwent LSC at our hospital and for whom follow-up was possible up to the second postoperative year were enrolled. Eighty-six patients received PTFE mesh and 125 received PP mesh. We compared patient demographics, perioperative data, 2-year outcomes, complications, and improvements in subjective urinary symptoms between the two groups.

Baseline characteristics were similar between the groups. One patient (1.2%) in the PTFE group experienced a Stage III cystocele recurrence 1 year postoperatively and required transvaginal mesh. The recurrence rate of POP-Q Stage II or higher at 2 years was 7.0% in the PTFE group and 4.8% in the PP group, with no statistically significant difference between groups. Improvements in subjective urinary symptoms over 24 months were similar in both groups, and no mesh-related or other postoperative complications were observed.

In this retrospective study with a two-year follow-up, LSC using PTFE mesh demonstrated clinical outcomes comparable to those achieved with PP mesh. These findings suggest that PTFE mesh may represent a reasonable alternative for LSC, although further prospective studies with longer follow-up are warranted.