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

Ansquer Yan, Marcollet Anne, Alves Karine, Fain Vanessa, Poncelet Christophe, Thoury Anne, Madelenat Patrick
European Journal of Obstetrics, Gynecology, and Reproductive Biology 2004 July 15, 115 (1): 90-4

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.

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