[Transobturator subvesical mesh: Tolerance and mild-term results. A prospective study]

M Kdous, F Zhioua
Journal de Gynécologie, Obstétrique et Biologie de la Reproduction 2008, 37 (8): 758-69

AIM: To evaluate midterm results, tolerance and efficiency of interposition of a transobturator subvesical mesh for the repair of cystoceles.

PATIENTS AND METHODS: We report the results of a total of 45 consecutive transobturator mesh fixation between March 1, 2005 and March 1, 2007. We used a transvaginal polypropylen tension-free mesh (Prolène, Ethicon, Johnson & Johnson, France) fixed through the obturator foramen.

RESULTS: Before surgery, all patients had cystocele of more or equal than grade II, according to Baden and Walker classification. Five had grade II cystocele (11%), 36 had grade III (80%) and four grade IV (9%). Thirty-nine women had associated median and/or posterior prolapse (86%). Eleven women had urinary incontinence (24%). The procedure was performed in all cases. Duration of a cystocele cure procedure was 25minutes+/-3.2 (12-32). Mean follow-up was 18 months+/-4.2 (13-29). Vaginal erosion ratio was 6%. There was no mesh infection. The objective success rate was 93%. The satisfaction index was 70%.

CONCLUSION: Transobturator mesh is a safe and efficient method for anterior segment prolapse repair. This procedure is simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance.

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