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Transvaginal Repair of Anterior Vaginal Wall Prolapse With Polyvinylidene Fluoride (Pvdf) Mesh: An Alternative for Previously Restricted Materials? Publisher Pubmed



Eslami MJ1 ; Zargham M1 ; Gholipour F2 ; Hajian M3 ; Bakhtiari K4 ; Hajebrahimi S5 ; Eghbal M6 ; Farajzadegan Z7
Authors
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Authors Affiliations
  1. 1. Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Department of Obstetrics & Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, United States
  5. 5. Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  6. 6. Department of Urology, Urmia University of Medical Sciences, Isfahan, Iran
  7. 7. Department of Community Medicine, Faculty of Medicine, Child Growth and Development Center, Isfahan University of Medical Sciences, Isfahan, Iran

Source: International Urogynecology Journal Published:2022


Abstract

Introduction and hypothesis: To study the mid-term safety and functional outcomes of transvaginal anterior vaginal wall prolapse repair using polyvinylidene fluoride (PVDF) mesh (DynaMesh®-PR4) by the double trans-obturator technique (TOT). Methods: Between 2015 and 2020, we prospectively included women with symptomatic high-stage anterior vaginal wall prolapse with or without uterine prolapse or stress urinary incontinence (SUI) in the study. The patients underwent transvaginal repair of the prolapse using PVDF mesh in two medical centers. We followed all patients for at least 12 months. We recorded the characteristics of vaginal and sexual symptoms, urinary incontinence, and prolapse stage pre- and postoperatively using International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS), International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF), and Pelvic Organ Prolapse Quantification (POP-Q) system, respectively. Results: One hundred eight women were included in the final analysis with a mean follow-up time of 34.5 ± 18.6 months. The anatomical success was achieved in 103 (95.4%) patients. There was a significant improvement in patients’ vaginal symptoms, urinary incontinence, and quality of life scores postoperatively (p < 0.0001). Only six patients (5.5%) had mesh extrusion, five of whom were managed successfully. The total rates of complications and de novo urinary symptoms were 21.3% and 7.4%, respectively. Significant pain was reported in 17 cases (15.7%). Conclusion: Our findings show that using PVDF mesh in the double TOT technique for anterior vaginal wall prolapse repair is a safe procedure with high anatomic and functional success rates and acceptable complication rates in mid-term follow-up. © 2021, The International Urogynecological Association.
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