Transvaginal PVDF-mesh for cystocele repair: A cohort study

Int J Surg. 2017 Mar:39:249-254. doi: 10.1016/j.ijsu.2017.02.006. Epub 2017 Feb 10.

Abstract

Introduction: Optimized biocompatibility of new materials is a major requirement for transvaginal meshes for pelvic organ prolapse (POP) repair. Polyvinylidene fluoride (PVDF) presented good characteristics in prior animal experiments and clinical use in humans.

Methods: Between 01/2012 and 04/2016 37 women underwent transvaginal repair of symptomatic prolapse of the anterior vaginal wall (cystocele) with PVDF-mesh in a single institution. A chart review for recurrence, continence, peri- and early postoperative complications was performed. Referring practitioners were interviewed by telephone and mail. Additionally patient reported outcome and satisfaction were measured by Patient Global Improvement Inventory (PGI-I) scale.

Results: 34 women were eligible for a mean follow up of 19 months. The functional outcome improved significantly. One symptomatic vault prolapse (2.9%) and two reoperations for incontinence (5.9%) occurred. Two mesh exposures (5.9%) occurred and were treated conservatively. No other severe complications were registered. 87.5% of treated women felt very much better or much better and would undergo the surgery again. A cohort study including development steps in accordance with the IDEAL system is presented.

Conclusions: For the first time we report on effectivity and safety of transvaginal application of PVDF-mesh in real-life practice. A prospective long-term evaluation in a registry is justified.

Keywords: Alloplastic material; Anterior mesh; Biocompatibility; Cystocele; IDEAL; Vaginal wall prolapse.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Biocompatible Materials
  • Cohort Studies
  • Colpotomy / instrumentation
  • Colpotomy / methods
  • Cystocele / surgery*
  • Female
  • Humans
  • Middle Aged
  • Patient Satisfaction
  • Polyvinyls
  • Postoperative Complications
  • Prostheses and Implants
  • Reoperation
  • Retrospective Studies
  • Surgical Mesh*
  • Treatment Outcome
  • Urinary Incontinence / surgery
  • Vagina / surgery

Substances

  • Biocompatible Materials
  • Polyvinyls
  • polyvinylidene fluoride