Transvaginal treatment of anterior or central urogenital prolapse using six tension-free straps and light mesh

Objective To evaluate the feasibility, efficacy, complications, and outcomes of treatment of anterior or central compartment urogenital prolapse by placement of an anteroposterior 22-g/m 2 mesh with six straps through one anterior vaginal incision. Methods In a prospective study, patients treated for urogenital prolapse at a center in France between February 2008 and June 2011 were enrolled. Previous treatments, related interventions, intraoperative and postoperative complications, and anatomic outcomes were recorded during 3 years of follow-up. Failure was defined as recurrence of prolapse of stage II or higher according to the Pelvic Organ Prolapse Quantification system. Results Overall, 74 patients were included. Preoperatively, 55 (74%) patients had stage III cystocele, 13 (18%) had stage IV cystocele, and 44 (59%) had associated uterine prolapse of at least stage II. Postoperative hematoma occurred in three patients and vaginal exposure in two patients. There were no cases of visceral injury. Vaginal comfort improved postoperatively: 68 (92%) patients were satisfied with the outcome and there were no cases of de novo dyspareunia. Seventeen (23%) patients subsequently had stress urinary incontinence that was treated by placement of suburethral tape. The anatomic outcomes were satisfactory for 72 (97%) women, including sexually active patients. Conclusion Transvaginal prolapse repair by placement of an anteroposterior six-strap 22-g/m 2 mesh was feasible and effective with satisfactory 3-year outcomes.