Transvaginal mesh surgery for anterior apical prolapse of the pelvic organs in women

Abstract

The study objective is to evaluate the effectiveness and safety of the 6-arm mesh OPUR implant in treatment of anterior apical prolapse. Materials and methods. Three hundred patients with anterior apical prolapse (grade III–IV cystocele, grade II–IV hysteroptosis) underwent surgery. Prolapse repair was performed using the 6-arm mesh OPUR implant.Results. In 290 patients, the intended result was achieved (full prolapse elimination or stage I prolapse per the POP-Q (Pelvic Organ Prolapse Quantification System)). However, in 6 cases recurrences of hysteroptosis, in 4 cases recurrences of cystocele were diagnosed. The following postoperative complications were observed: hematoma of the anterior vaginal wall with spontaneous resorption in 12 patients; acute urinary retention resolved in 3–7 days after the surgery in 5.8 % cases; vaginal mucosa erosion in 4 cases (in 2 cases, fragment resection was necessary); intraoperative injury of the bladder in 3 patients (in 2 cases, prolapse repair after defect suturing was finished with transvaginal contralateral sacrospinous hysteropexy supplemented by anterior colporrhaphy; in 1 case, bladder defect was sutured prior to implantation). Conclusion. Transvaginal repair of anterior apical prolapse of the pelvic organs in women using the 6-arm implant is effective and relatively safe. Satisfactory anatomical results persisting for a long time (4–5 years) after implantation were achieved.