[Use of transvaginal polypropylene mesh (Gynemesh) for the treatment of pelvic floor disorders in women. Prospective study in 52 patients].

Abstract

OBJECTIVES: To evaluate the efficacy and safety of strict transvaginal implantation of a non-resorbable synthetic prosthesis (Gynemesh) for the treatment of female genital prolapse. MATERIALS AND METHODS: The anatomical and functional results of 52 women operated between September 1999 and December 2002 were evaluated prospectively. The mean age of the patients was 62 years. All patients presented a cystocele, associated with a hysterocele, an elytrocele or a rectocele in 28%, 9.5% and 38% of cases, respectively. Urinary incontinence was reported in 65% of patients, and 30% of women had a history of previous pelvic surgery. Depending on the components of the prolapse, the operation comprised anterior or posterior mesh implantation, hysterectomy and TVT insertion. Patients were reviewed by a different surgeon from the operator at 3 months, 6 months and then annually. RESULTS: With a mean follow-up of 27 months, the anatomical success rate was 95% for correction of cystocele, and 100% for correction of rectocele. Vaginal erosion by the mesh occurred in two cases after cystocele repair (3.8%). CONCLUSION: Transvaginal implantation of a polypropylene prosthesis is a safe and reproducible technique, which is effective in the medium term for the treatment of prolapse, but further studies are required to confirm this technique as a valid alternative to existing techniques.