Cystocele repair by vaginal route: comparison of three different surgical techniques of mesh placement

• Published in: International Urogynecology Journal 2012-06, Vol.23 (6), p.699-706
• Main Authors: Mourtialon, Pascal, Letouzey, Vincent, Eglin, Georges, de Tayrac, Renaud
• Format: Article
• Language: English
• Subjects: Aged; Coated Materials, Biocompatible; Cystocele - psychology; Cystocele - surgery; Female; Follow-Up Studies; Gynecology; Humans; Medicine; Medicine & Public Health; Middle Aged; Natural Orifice Endoscopic Surgery - methods; Original Article; Patient Satisfaction; Pelvic Organ Prolapse - diagnosis; Pelvic Organ Prolapse - psychology; Pelvic Organ Prolapse - surgery; Polypropylenes; Prospective Studies; Quality of Life; Surgical Mesh; Surveys and Questionnaires; Time Factors; Treatment Outcome; Urologic Surgical Procedures - methods; Urology; Vagina
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-011-1650-6

Introduction and hypothesis Different techniques of mesh placement for cystocele repair are known. Our goal was to compare anatomical and functional outcomes of three different techniques of mesh placement over a 3-year follow-up. Methods Between March 2003 and June 2004, 230 patients (stage 2–4 pelvic organ prolapse (POP)) were included in a prospective study. For cystocele repair, mesh was implanted either with two arms into the retropubic space (RP) or with two to four arms into the obturator foramen (TO), or fixed to the arcus tendineous fascia pelvis (FG). Results Patients' distribution is as follows: 142 TO, 32 RP, and 31 FG. Anatomical success (cystocele < stage 2 in the POP staging system) was clearly poorer after the retropubic free technique, with success rates of 69% (RP), 90.1% (TO), and 96.6% (FG) ( p  = 0.004). POP distress inventory ( p