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Long-term experience with a novel uterine-sparing transvaginal mesh procedure for uterovaginal prolapse.

Authors :
Nicita, Giulio
Villari, Donata
Li Marzi, Vincenzo
Milanesi, Martina
Saleh, Omar
Jaeger, Tommaso
Martini, Alberto
Source :
European Journal of Obstetrics & Gynecology & Reproductive Biology. Mar2018, p57-63. 7p.
Publication Year :
2018

Abstract

<bold>Objectives: </bold>To evaluate outcomes and quality of life in patients operated transvaginally with an original mesh shape for uterus-sparing prolapse surgery and to demonstrate the safety and efficacy of the technique.<bold>Study Design: </bold>We prospectively evaluated 66 postmenopausal patients (POP-Q Stage III: 32, IV: 34) operated between May 2008 and December 2013. We used wide weave polypropylene monofilament mesh that functions as a hammock anchored posteriorly to sacrospinous ligaments, its anterior wings exit the pelvis through the obturatory membrane. Follow-up was scheduled at 3-, 12- months and in May 2016. Prolapse-Quality of Life Questionnaire (P-QoL) was administered preoperatively, at 12 months and in May 2016. The chi square and Wilcoxon test were used for statistical analysis.<bold>Results: </bold>Mean follow-up was 5.6 (SD: 1.6, Range: 1.1-8.1) years. The overall success rate (POP-Q ≤ 2) was 92.5% at 12 months and 84.4% at May 2016, these data remained stable over time (p > 0.05). Early complications occurred in 2 (3%) patients, late in 5 (7.8%) of which mesh extrusion in 4 (6.3%). Data from P-QoL showed significant improvement between preoperative and postoperative data (P < 0.01 for all domains) and they remained stable with time (p > 0.05). De-novo dyspareunia was 17.6% at 12 months and 10.3% at May 2016.<bold>Conclusions: </bold>The low rate and grade of complications demonstrates the safety of the procedure, which offers stable anatomical correction with significant improvement in QoL. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03012115
Database :
Academic Search Index
Journal :
European Journal of Obstetrics & Gynecology & Reproductive Biology
Publication Type :
Academic Journal
Accession number :
128002293
Full Text :
https://doi.org/10.1016/j.ejogrb.2018.01.003