To assess the outcomes of surgical repair of anterior apical prolapse using the 6-strap mesh implant.
The prospective study included 100 patients with genitourinary prolapse. We used advanced 6-strap mesh implant. The results were assessed at 1 (n = 100) and 12 (n = 93) months after surgery. Maximum follow-up was over 4 years. The anatomical outcomes according to the Pelvic Organ Prolapse Quantification system and intraoperative and postoperative complications were assessed. Stage II and higher prolapse was considered to be a recurrence. The quality of life and sexual function were assessed using Pelvic Organ Prolapse Distress Inventory 20, Pelvic Floor Impact Questionnaire 7, and Pelvic Organ Prolapse/Incontinence Sexual Questionnaire 12.
Median age was 57 years (34-78 years (95% confidence interval)). All patients had stage III cystocele. The anterior vaginal wall descent in all the patients was associated with uterine descent: 37 (37%), stage II; 60 (60%), stage III; in 3 (3%), stage IV. In eight cases, postoperative de novo stress urinary incontinence developed. The quality of life improved in 93 (93%) women as judged by the Pelvic Floor Distress Inventory 20 data and in 87 (87%) women, according to the Pelvic Floor Impact Questionnaire 7 data. The desirable anatomical result (ā©½stage I according to the Pelvic Organ Prolapse Quantification system) was achieved in 97 (97%) patients. With the exception of mesh fragment excision due to erosion (grade 3a), all the complications were classified as grade I according to the Clavien-Dindo classification.
Genitourinary prolapse repair using 6-strap mesh is efficacious and relatively safe. The method demonstrates good anatomical results in relation to both anterior and apical prolapses with relatively short-term complications.
Urologia. 2019 Dec 16 [Epub ahead of print]
Mikhail Elikovich Enikeev, Dmitry Victorovich Enikeev, Dmitry Olegovich Korolev, Olesya Vyacheslavovna Snurnitsyna, Mikhail Vladimirovich Lobanov, Aleksandr Nikolaevich Nikitin, Leonid Mikhailovich Rapoport, Petr Vitalievich Glybochko
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia., Spasokukotsky City Clinical Hospital, Moscow, Russia.