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A Journal on Obstetrics and Gynecology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
Minerva Ginecologica 2007 August;59(4):369-76
Tension-free cystocele repair: an analysis after a follow-up of 24 months
Granese R. 1, Adile B. 2
1 Department of Obstetrics and Gynaecology, University of Messina, Messina, Italy
2 Urogynaecology Department, Villa Sofia-C.T.O. Hospital, Palermo, Italy
Aim. The aim of the study is to verify whether tension free cystocele repair is really a good choice for the correction of moderate or severe cystocele. The surgical approach is transvaginal and involves the use of nonabsorbable prolene mesh.
Methods. We enrolled 177 women with a combined genital prolapse, characterized by second degree cystocele, first degree hysterocele and first degree rectocele or more severe conditions. All the patients underwent a complete urogynaecological work-up before the surgical treatment consisting in a Y-shaped mesh placed on the prevesical fascia. This technique was implemented providing a tension free prothesis.
Results. Our results on a total of 169 patients after a follow-up of 24 months are the following: 19 patients (11%) reported a recurrent cystocele (grade II) of which 9 patients at 6 months follow-up presented a vaginal wall erosion that determined a surgical explantation of the mesh; 2 patients (1%) showed a persistent dyspareunia and were treated with estrogen therapy that gave an improvement of the syntomatology although it did not disappear; 10 (6%) patients, among the women treated only for cystocele repair (cystocele III ), complained of stress urinary incontinence of 1st degree; and, finally, 150 patients (89%) didn’t report any recurrence of cystocele.
Conclusion. Given the good results obtained after a follow-up of 24 months (89% of the cure rate), we can consider this procedure simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance. It is a promising approach in the management of pelvic floor dysfunctions that induces minimal foreign body reaction.