Transobturator mesh for cystocele repair: a short- to medium-term follow-up using 3D/4D ultrasound
Shek, K.L., Dietz, H.P., Rane, A., and Balakrishnan, S. (2008) Transobturator mesh for cystocele repair: a short- to medium-term follow-up using 3D/4D ultrasound. Ultrasound in Obstetrics & Gynecology, 32 (1). pp. 82-86.
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Objective: Anterior colporrhaphy has been shown to have limited medium-term success rates in cystocele repair. Many clinicians use mesh implants, but their safety and efficacy are controversial. We therefore performed an external surgical audit using three- and four-dimensional pelvic floor ultrasound to study the short- to medium-term results of transobturator mesh placement.
Methods: Forty-six women who had undergone transobturator mesh anterior repair using the Perigee™ system were invited back for a follow-up appointment conducted by two non-surgeons. The appointment consisted of a standardized interview, clinical examination using the International Continence Society Pelvic Organ Prolapse Quantification system (ICS POP-Q) and translabial ultrasound examination.
Results: The mean follow-up time was 10 (range, 2-24) months. There had been no major intra- or postoperative complications. Thirty-six (78%) patients were subjectively satisfied with the outcome of the procedure. Cystocele recurrence (Stage 2 or 3) was observed in six (13%) patients. There were three (6.5%) cases of mesh erosion. On translabial ultrasound, we observed cystocele recurrence dorsal to the mesh in five women, associated with a marked change in mesh axis on Valsalva, implying dislodgment of the superior anchoring arms. The mesh was measured at a mean of 21 (range, 8.8-37.3; SD, 7.0) mm in length.
Conclusions: At 10-month follow-up the Perigee procedure seems to be safe and effective for cystocele repair, with a satisfaction rate of 78%. In some women recurrence may occur due to dislodgment of the superior anchoring arms.
|Item Type:||Article (Refereed Research - C1)|
|Keywords:||3D/4D ultrasound; anterior colporrhapy; cystocele; perigee; transobturator mesh|
|Date Deposited:||25 Mar 2010 03:25|
|FoR Codes:||11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111402 Obstetrics and Gynaecology @ 100%|
|SEO Codes:||92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920114 Reproductive System and Disorders @ 100%|
|Citation Count from Web of Science||