Abdominal mesh sacrocolpopexy for recurrent triple-compartment pelvic organ prolapse

Jason P Gilleran, Philippe Zimmern
BJU International 2009, 103 (8): 1090-4

OBJECTIVE: To report the short- and intermediate- term outcome of safety and efficacy after abdominal-mesh sacrocolpopexy (MSC) for recurrent anterior, posterior and vault ('triple-compartment') pelvic organ prolapse (POP).

PATIENTS AND METHODS: In a database review we identified non-neurogenic women who had MSC for recurrent triple-compartment POP and with a >or=6-month cystographic follow-up. The preoperative evaluation included a history, physical examination, Urogenital Distress Inventory (UDI-6) and visual analogue quality-of-life (QoL) questionnaires, urodynamic studies, and a standing lateral voiding cysto-urethrogram (VCUG) with rest-strain views. All surgery as performed by the same surgeon, using polypropylene (Marlex) mesh. Perioperative data, the VCUG at 6 months, and interval pelvic examinations were recorded.

RESULTS: Between 2000 and 2006, 29 postmenopausal women (Caucasian, mean age 64 years, sd 11) underwent MSC. The mean (sd, range) operative duration was 228 (75, 170-340) min, the estimated blood loss 150 (100) mL and the inpatient stay 3 (1) days. At a mean (sd) follow-up of 23 (16) months, the physical examination showed no evidence of POP of grade >or=2, with mean POP-Quantification scores of -2.8 (0.4), -2.9 (0.4) and -9.3 (0.8) for points A(a), A(p) and C, respectively. Two patients (8%) had evidence of grade >or=2 cystocele at the 6-month VCUG. After MSC, four of the six UDI and the QoL scores were significantly lower at the last follow-up than at baseline, with no change in sexual or defecatory function.

CONCLUSIONS: The objective and subjective improvement at the short and intermediate follow-up after MSC suggest that this is a safe and effective treatment for recurrent triple-compartment POP.

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