Objective: Up to 80% of all POP surgical procedures are due to anterior vaginal wall prolapse. The aim of this study is to evaluate the efficacy and safety of transvaginal anterior mesh for POP surgical repair.
Materials And Methods: 153 consecutive patients with symptomatic or recurrent anterior vaginal prolapse undergoing surgical single-incision mesh (Calistar S) were prospectively enrolled in the study. Preoperative evaluation was performed collecting urogynecological history and performing a clinical exam, 3-day voiding diary and urodynamic testing. All incontinent patients completed the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Operative time, blood loss, perioperative and postoperative complications were prospectively recorded. Postoperative follow-up was scheduled at 1, 6, and 12 months with a urogynecological interview and examination. Success rate was assessed at 1, 6 and 12 months postoperatively.
Results: The median follow-up was 16.4 months. None of patients had intraoperative complications. Eight patients (5%) required surgical intervention for complications (5 patients (3%) for haematoma and 3 (2%) for vaginal erosion). At 12 months of follow up 130 out of 140 patients (93%) gained the subjective cure criterion, while 129 out of 140 patients (92%) obtained the objective cure criterion. Eleven (7.8%) patients experienced stage 2 or higher prolapse recurrence and three of them with a stage ≥3 underwent reintervention. No significant differences were recorded in primary outcome at 1, 6 or 12 months postoperatively.
Conclusions: Anterior compartment prolapse repair by Calistar S (single-incision vaginal mesh) is an effective and safe procedure without significant complications.
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http://dx.doi.org/10.1016/j.tjog.2021.10.007 | DOI Listing |
BMC Surg
December 2024
Department of Obstetrics & Gynecology, Peking University Third Hospital, No. 49 Huayuan North Road, Haidian District, Beijing, 100191, China.
Introduction And Hypothesis: To investigate the mid-term outcomes of transvaginal repair for moderate-severe cystocele using autologous fascia lata harvested through a single small incision.
Methods: Between February and October 2022, 35 patients with moderate to severe cystocele undergoing transvaginal repair with autologous fascia lata were included. Patient demographics and perioperative data were collected, with follow-ups through outpatient visits or phone calls.
Cureus
November 2024
Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University) Pune, Pune, IND.
Urethrovaginal fistulas are rare complications often arising from urethrovaginal injuries commonly due to obstetrical trauma, urethral surgeries, pelvic fractures, or neoplastic treatments. Here, we present a unique case involving a 23-year-old female patient with a large urethrovaginal fistula and complete anterior vaginal wall sloughing following prolonged obstructed labor. Nine months post-cesarean, she reported urine leakage via the vagina upon catheter removal, which intensified in an erect posture.
View Article and Find Full Text PDFArch Gynecol Obstet
December 2024
Department of Gynecology, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, ErQi District, Zhengzhou, 450001, China.
Background: Stress urinary incontinence (SUI) is prevalent among women, often occurring alongside anterior vaginal wall prolapse. This study compares the efficacy and safety of an improved vaginal wall repair technique with pubocervical fascia fixation versus standard anterior colporrhaphy for treating SUI in women with anterior vaginal wall prolapse.
Methods: A single-centre, parallel-group, randomised controlled trial was conducted between September 2021 and June 2024.
Int Urogynecol J
December 2024
Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, 3168, Australia.
Introduction And Hypothesis: Autologous fascia lata has been increasingly utilised in pelvic floor reconstructive surgeries such as sacrocolpopexy and sacrohysteropexy. This case highlights sacrohysteropexy with autologous fascia lata as a promising option for women with advanced uterovaginal prolapse who wish to preserve their uterus and avoid synthetic mesh.
Methods: We report the case of a 65-year-old woman with stage 3 pelvic organ prolapse following one forceps and one spontaneous vaginal delivery.
Case Rep Womens Health
December 2024
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
Anterior exenteration is a radical surgical option for treating locally advanced pelvic malignancies when alternative treatments are deemed ineffective or inappropriate. Due to its nature as an ablative treatment, interference with supportive structures of the pelvic floor can result in pelvic organ prolapse. A 70-year-old woman presented with prolapse after radical cystectomy and following two unsuccessful attempts at Le Fort colpocleisis, the second of which was further complicated by rupture of the vaginal cuff.
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