Cystocele repair by a synthetic vaginal mesh secured anteriorly through the obturator foramen.

OBJECTIVE: Our aim was to assess the feasibility and short-term results of cystocele repair by the placement of a synthetic subvesical mesh secured anteriorly through the obturator foramen.

STUDY DESIGN: Between 1 November 2001 and 31 July 2002, 30 consecutive patients with a grade 2 (n = 18, 60%) or 3 (n =12, 40%) cystocele were prospectively included in the study.

RESULTS: The obturator route was feasible in all cases. No intraoperative complications arose. After a mean follow-up of 6.7 months (range: 2-12), 90% (n = 27) of the patients were cystocele grade 0, 7% (n = 2) grade 1 and failure was observed in a young patient (3%) treated without hysterectomy. Two vaginal erosions (7%) were observed at six and nine months. For the 14 patients (47%) who had sexual relations after surgery, 2 (14%) complained of anterior dyspareunia.

CONCLUSION: The obturator approach is a simple and sure technique for placing a polypropylene synthetic subvesical mesh. The long term stability and tolerance of the results must be confirmed.