FEMALE GENITAL PROLAPSE SURGERY USING ULTRA LIGHTWEIGHT POLYPROPYLENE MESH


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Abstract

Aim To compare the results of female genital prolapse (FGP) surgery via vaginal access using lightweight and ultra-lightweight polypropylene mesh. Materials and methods From 2007 to 2011, 93 women aged from 46 to 71 years with II-IV stage FGP (POP-Q classification) were examined and underwent the vaginal extra-peritoneal colpopexy using polypropylene implants in the Department of Urology. Patients were divided into 2 groups. In patients ofgroup 1 (n=50) the surgery was performed according to a newly developed technique using perforated ultra-lightweight (surface density 19 g/m2) domestically manufactured polypropylene implant. In group 2, a standard trocar set with light (surface density of 42.7 g/m2) foreign-made polypropylene implants was used. Results and discussion Long-term follow-up was from 1 to 5 years. General surgical complications (urinary bladder injury, blood loss over 300 ml, perineal and vaginal hematomas) were detected in 2 (4%) patients of group 1 and in 7 (16.3%) patients of group 2. The most common specific mesh-related complication was the vaginal wall erosion, which was observed in 4 (9.3%) patients of group 2 and in 1 (2%) patient of group 1. FGP recurrence was diagnosed in 5 (10%) patients of group 1 in the non-treated part and in 8 (18.6%) patients of group 2. Three patients (7%) in group 2 developed recurrent cystocele due to the shrinkage of the mesh implant which was not observed in group 1. At 12 month follow-up, the results of FGP surgical treatment were estimated as good (full functional Conclusion We have developed a method of vaginal extra-peritoneal colpopexy using a perforated ultra-lightweight polypropylene implant. This technique has resulted in the absence of recurrence in the treated part of FGP, and 4.1, 4.2 and 4.7 fold reductions in the incidence of general surgical complications, vaginal wall erosions and perineal and vaginal hematomas, respectively, compared with FGP patients undergoing the placement of the lightweight polypropylene implant using the standard trocar set.

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About the authors

V. B Filimonov

FPE of Ryazan SMU of Minzdrav of Russia; Peoples’ Friendship University of Russia; Ryazan Regional Clinical Hospital

Professor at Department of Surgery and Obstetrics-Gynecology; Dr.Med.Sci., Professor at the Department of Urology, Oncology and Radiology, FPE of Medical Institute; Head of the Urology Department Ryazan

R. V Vasin

FPE of Ryazan SMU of Minzdrav of Russia; Peoples’ Friendship University of Russia; Ryazan Regional Clinical Hospital

Associate Professor at Department of Surgery and Obstetrics-Gynecology; PhD, Associate Professor at the Department of Urology, Oncology and Radiology, FPE of Medical Institute; Urologist at the Urology Department Ryazan

I. V Vasina

Peoples’ Friendship University of Russia; Ryazan Regional Clinical Hospital

Teaching Assistant at the Department of Urology, Oncology and Radiology, FPE of Medical Institute; Gynecologist at the Department of Gynecology Ryazan

A. D Kaprin

National Medical Radiological Research Center; Peoples’ Friendship University of Russia

Academician of the RAS, Dr.Med.Sci., Professor, Honoured Physician of the Russian Federation, Director General; Head of the Department of Urology and Operative Nephrology with the Course of Oncourology, Medical Faculty of Medical Institute; Chief Urologist of the RAS Ryazan

A. A Kostin

National Medical Radiological Research Center; Peoples’ Friendship University of Russia

Dr.Med.Sci., Professor, First Deputy Director General; Head of the Department of Urology, Oncology and Radiology Ryazan

References

  1. Nygaard I., Brubaker L., Zyczynski H.M., Cundiff G., Richter H., Gantz M., Fine P., Menefee S., Ridgeway B., Visco A., Warren L.K., Zhang M., Meikle S. Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA. 2013;309(19):2016-2024.
  2. Perinatology: Diseases of the female perineum in obstetric-gynecology, sexology, urology. Ed. V.E. Radzinskii. M.: OOO «Meditsinskoe informatsionnoe agentstvo». 2006;336 p.
  3. Sharifulin M.A., Protopopova N.V., Kravchenko N.A., Burdukova N.V. The correction of genital prolapse using synthetic materials. Sibirskii meditsinskii zhurnal. 2012;7:121-122
  4. Malkhasyan V.A. Anatomic-functional state of the lower urinary tract in women with pelvic organ prolapse after extraperitoneal vaginopexy (Prolift operation): PhD Thesis: M., 2012;25 p
  5. Altman D., Väyrynen T., Engh M.E., Axelsen S., Falconer C. Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N. Engl. J. Med. 2011;364(19):1826-1836.
  6. Abramyan K.N. Prevention and treatment of complications of extraperitoneal vaginopexy (Prolift operations): PhD Thesis: M. 2011 ;25 s.
  7. Shkarupa D.D., Shpilenya E.S., Kubin N.D. The main problems associated with the use of synthetic mesh implants in the vaginal surgery urinary incontinence and pelvic organ prolapse at the present stage. Meditsinskii vestnik Bashkortostana. 2013;8(3):172-175
  8. Withagen M.I., Milani A.L., den Boon J., Vervest H.A., Vierhout M.E. Re: Trocar-Guided Mesh Compared With Conventional Vaginal Repair in Recurrent Prolapse. Obstet Gynecol. 2011;117:242-250.
  9. Kaprin A.D., Filimonov V.B., Vasin R.V., Vasina I.V., Vasin I.V., Kostin A.A. Morphological characteristic of reaction of the bladder and the vagina tissues to fixing to them polypropylene mesh implants in the experiment. Eksperimental’naya i klinicheskaya urologiya. 2013;1:24-29.
  10. Soluyanov M.Yu., Lyubarskii M.S., Koroleva E.G., Rakitin F.A. Errors and complications of surgical treatment of pelvic organ prolapse using synthetic materials. Uspekhi sovremennogo estestvoznaniya. 2012;10:48-52
  11. Chechneva M.A. Rational concept of integrated survey of women with pelvic organ prolapse and urinary incontinence: Dr.Med. Sci. Thesis: M. 2011;49 p
  12. Filimonov V.B., Vasin R.V., Kaprin A.D., Kostin A.A., Vasina I.V. Method of vaginal extraperitoneal colpopexy using a perforated implant. RF Patent number 2538796 IPC A61 B17 / 42 (2006.01); Application № 2013102790/14, 05.02.2013, published.10.01.2015. Byul.1
  13. McCall M.L. Posterior culdeplasty; surgical correction of enterocele during vaginal hysterectomy; a preliminary report. ML. McCall. Obstet. Gynecol. 1957;10:595-602.
  14. Shkarupa D.D., Gorgotskii I.A., Yarova N.P., Shkarupa E.A. A prospective study of the effectiveness of the surgical reconstruction of the pelvic floor using ultra-light mesh implants «Pelviks». Eksp. i klin. urologiya. 2012;3:90-96.

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