Trans-vaginal cystocele repair using a tension-free polypropylene mesh: more than 5 years of follow-up.

OBJECTIVES

Prospective randomized controlled trials, with 2 years' follow-up, seem to lean in favour of anterior repair using synthetic mesh. The goal of this study was to report on long-term (>5 years) follow-up.

STUDY

DESIGN

Polypropylene mesh was inserted in 63 women (in 1999-2001) from the retropubic space to under the bladder using a tension-free technique.

RESULTS

At 79 months' follow-up, 45 women were anatomically cured (76%). Four (7%) were lost to follow-up and 14 (24%) presented with stage 2 or 3 cystocele recurrences. None of them required surgery for cystocele recurrence. Vaginal extrusion was reported in 10 (16%) patients (in four cases after 4 years of follow-up) and all required partial surgical removal of the mesh (n=10, 16%).

CONCLUSION

Cystocele repair using tension-free polypropylene mesh is associated with a low long-term rate of repeat surgery for cystocele recurrence.