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

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.