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Transobturator mesh for cystocele repair: a short‐ to medium‐term follow‐up using 3D/4D ultrasound
Author(s) -
Shek K. L.,
Dietz H. P.,
Rane A.,
Balakrishnan S.
Publication year - 2008
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.5361
Subject(s) - medicine , surgery , ultrasound , surgical mesh , patient satisfaction , physical examination , pelvic floor , radiology , hernia
Objective Anterior colporrhaphy has been shown to have limited medium‐term success rates in cystocele repair. Many clinicians use mesh implants, but their safety and efficacy are controversial. We therefore performed an external surgical audit using three‐ and four‐dimensional pelvic floor ultrasound to study the short‐ to medium‐term results of transobturator mesh placement. Methods Forty‐six women who had undergone transobturator mesh anterior repair using the Perigee TM system were invited back for a follow‐up appointment conducted by two non‐surgeons. The appointment consisted of a standardized interview, clinical examination using the International Continence Society Pelvic Organ Prolapse Quantification system (ICS POP‐Q) and translabial ultrasound examination. Results The mean follow‐up time was 10 (range, 2–24) months. There had been no major intra‐ or postoperative complications. Thirty‐six (78%) patients were subjectively satisfied with the outcome of the procedure. Cystocele recurrence (Stage 2 or 3) was observed in six (13%) patients. There were three (6.5%) cases of mesh erosion. On translabial ultrasound, we observed cystocele recurrence dorsal to the mesh in five women, associated with a marked change in mesh axis on Valsalva, implying dislodgment of the superior anchoring arms. The mesh was measured at a mean of 21 (range, 8.8–37.3; SD, 7.0) mm in length. Conclusions At 10‐month follow‐up the Perigee procedure seems to be safe and effective for cystocele repair, with a satisfaction rate of 78%. In some women recurrence may occur due to dislodgment of the superior anchoring arms. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.