BJOG : an international journal of obstetrics and gynaecology · 2005
Functional and anatomical outcome of anterior and posterior vaginal prolapse repair with prolene mesh.
Оценочное исследованиеСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Milani Rodolfo, Salvatore Stefano, Soligo Marco, Pifarotti Paola, Meschia Michele, Cortese Marina
Аннотация
OBJECTIVE: To evaluate the effects of prolene mesh on urinary, bowel and sexual function in prolapse surgery.
DESIGN: Prospective observational study on consecutive women.
SETTING: Two referral uorgynaecological units in Italy.
POPULATION: Women requiring prolapse repair for anterior or posterior vaginal prolapse.
METHODS: All women were assessed for urinary, bowel, prolapse symptoms and dyspareunia pre- and post-operatively. Urodynamics was performed in selected cases. Surgery consisted of an anterior or posterior repair plus a prolene mesh. Follow up was after 1, 6 and 12 months. The ANOVA test was used for statistical analysis.
MAIN OUTCOME MEASURES: Vaginal anatomical restoration, urinary, bowel and sexual function.
RESULTS: We recruited 63 women (mean age 63 years) with a mean follow up of 17 months. Anatomically, the success rate was 94%. Thirty-two women had an anterior repair. Among this group, the sexual activity rate did not alter but dyspareunia increased by 20%. Urge and stress incontinence did not change post-operatively but urgency improved in 10% and 13% had vaginal erosion of the mesh. Thirty-one women had a posterior repair. Among this group, sexual activity decreased by 12% and dyspareunia increased in 63%. Constipation improved in 15% and anal incontinence in 4%, and 6.5% of women had vaginal erosion of the mesh and one required mesh removal for pelvic abscess.
CONCLUSIONS: Although this study shows good anatomical results with the use of prolene mesh for prolapse repair, there was a high rate of morbidity. We believe that the use of prolene mesh should be abandoned.
DESIGN: Prospective observational study on consecutive women.
SETTING: Two referral uorgynaecological units in Italy.
POPULATION: Women requiring prolapse repair for anterior or posterior vaginal prolapse.
METHODS: All women were assessed for urinary, bowel, prolapse symptoms and dyspareunia pre- and post-operatively. Urodynamics was performed in selected cases. Surgery consisted of an anterior or posterior repair plus a prolene mesh. Follow up was after 1, 6 and 12 months. The ANOVA test was used for statistical analysis.
MAIN OUTCOME MEASURES: Vaginal anatomical restoration, urinary, bowel and sexual function.
RESULTS: We recruited 63 women (mean age 63 years) with a mean follow up of 17 months. Anatomically, the success rate was 94%. Thirty-two women had an anterior repair. Among this group, the sexual activity rate did not alter but dyspareunia increased by 20%. Urge and stress incontinence did not change post-operatively but urgency improved in 10% and 13% had vaginal erosion of the mesh. Thirty-one women had a posterior repair. Among this group, sexual activity decreased by 12% and dyspareunia increased in 63%. Constipation improved in 15% and anal incontinence in 4%, and 6.5% of women had vaginal erosion of the mesh and one required mesh removal for pelvic abscess.
CONCLUSIONS: Although this study shows good anatomical results with the use of prolene mesh for prolapse repair, there was a high rate of morbidity. We believe that the use of prolene mesh should be abandoned.