STUDY OBJECTIVES: The study aims to assess the morphology of anterior armed transobturator collagen-coated polypropylene mesh and its clinical outcomes in pelvic reconstructive surgery for pelvic organ prolapse.
DESIGN: II-3 Evidence obtained from several timed series with intervention.
DESIGN: Classification: Case series.
SETTING: The study was done at Chang Gung Memorial Hospital from April 2010 till October 2012.
PATIENTS: 70 patients underwent prolapse surgery for symptomatic Pelvic Organ Prolapse (POP) stage III & IV, according to the Pelvic Organ Quantification System (POP-Q).
INTERVENTIONS: Anterior armed transobturator collagen-coated mesh.
MEASUREMENT: Morphology and Clinical outcome was measured. Morphology was assessed though 2-dimensional introital ultrasonography and doppler studies. Clinical outcome was measured through subjective and objective outcome. Objective outcome was assessed by the nine points site-specific staging by the International Continence Society (ICS) Pelvic Organ Prolapse Quantification (POP-Q) prior to the operation and 1 year post operative follow-up. subjective outcome was based on the four validated questionnaires: Urogenital Distress Inventory (UDI-6) , Incontinence Impact Questionnaire (IIQ-7), Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6) and the Pelvic Organ Prolapse/ Urinary Incontinence Sexual Questionnaire (PISQ-12) at baseline and 12 months after operation.
MAIN RESULTS: The data was based on 65 patients who had the combined surgery and was able to comply for follow-up for more than 1 year. On ultrasound, mesh length has a tendency to shorten and decrease in thickness over the one-year follow-up period. Vagina thickness also showed a reducing pattern. Neo-vascularization through the mesh was seen in less than 8.5 % of cases in the first month and at one year, around 83% were evident. The mesh exposure rate was 6.4 %. The recorded objective cure and subjective cure were 90.8% (59/65) and 89.2% (58/65) respectively in a mean follow-up period of 19.40 ± 10.98 months. UDI-6, IIQ-7, POPDI-6 scores all significantly reduced (p< .001) while the PISQ-12 score increased significantly at one year (p= .011).
CONCLUSIONS: Ultrasound features suggest that the degeneration collagen barrier may be longer than expected and integration of collagen-coated mesh could take place up to one year. Significantly good clinical outcome was noted in the study.
Written by:
Lo TS, Tan YL, Khanuengkitkong S, Dass AK, Cortes EF, Wu PY. Are you the author?
Division of Urogynecology, Department of Obstetrics and Gynecology, Taoyuan, Taiwan, Republic of China; Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China; Sarawak General Hospital, Kuching, Sarawak, Malaysia; Prince of Songkla University, Hatyai, Songkhla, Thailand; Penang Hospital, Penang, Malaysia; De La Salle University Medical Center, Dasmariñas Cavite, Philippines.
Reference: J Minim Invasive Gynecol. 2014 Mar 4. pii: S1553-4650(14)00192-7.
doi: 10.1016/j.jmig.2014.02.013
PubMed Abstract
PMID: 24607796
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