Cystocele repair by a synthetic vaginal mesh secured anteriorly through the obturator foramen

Eur J Obstet Gynecol Reprod Biol. 2004 Jul 15;115(1):90-4. doi: 10.1016/j.ejogrb.2003.05.007.

Abstract

Objective: Our aim was to assess the feasibility and short-term results of cystocele repair by the placement of a synthetic subvesical mesh secured anteriorly through the obturator foramen.

Study design: Between 1 November 2001 and 31 July 2002, 30 consecutive patients with a grade 2 (n = 18, 60%) or 3 (n =12, 40%) cystocele were prospectively included in the study.

Results: The obturator route was feasible in all cases. No intraoperative complications arose. After a mean follow-up of 6.7 months (range: 2-12), 90% (n = 27) of the patients were cystocele grade 0, 7% (n = 2) grade 1 and failure was observed in a young patient (3%) treated without hysterectomy. Two vaginal erosions (7%) were observed at six and nine months. For the 14 patients (47%) who had sexual relations after surgery, 2 (14%) complained of anterior dyspareunia.

Conclusion: The obturator approach is a simple and sure technique for placing a polypropylene synthetic subvesical mesh. The long term stability and tolerance of the results must be confirmed.

MeSH terms

  • Adult
  • Aged
  • Dyspareunia / epidemiology
  • Female
  • Humans
  • Length of Stay
  • Middle Aged
  • Postoperative Complications
  • Prospective Studies
  • Sexual Dysfunction, Physiological / epidemiology
  • Surgical Mesh*
  • Urinary Bladder Diseases / surgery*
  • Urinary Incontinence, Stress / epidemiology
  • Urinary Incontinence, Stress / surgery
  • Urinary Retention / epidemiology
  • Urologic Surgical Procedures / adverse effects
  • Urologic Surgical Procedures / instrumentation
  • Urologic Surgical Procedures / methods*
  • Vagina*
  • Vaginal Diseases / epidemiology
  • Vaginal Diseases / surgery