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Risk of the prolapse „de novo“ in primary unaffected compartment by using the syntethic mesh in the surgery treatment of the pelvic organe prolapse


Authors: P. Urdzík 1;  J. Galád 2;  A. Ostró 1
Authors‘ workplace: II. gynekologicko-pôrodnícka klinika LF UPJŠ a UN L. Pasteura, Košice, prednosta prof. MUDr. A. Ostró, CSc. 1;  Gynekologické oddelenie, Gynpor, s. r. o, Sliač, primár MUDr. J. Galád 2
Published in: Ceska Gynekol 2011; 76(4): 321-326

Overview

Objective:
The aim of this retrospective trial was to evaluate the risk of the prolapse „de novo“ in primary unaffected compartment by using the syntethic mesh.

Design:
Rerospective multicentric trial.

Setting:
2nd department of Gynaecology and Obstetrics, Medical Faculty of Safarik’s University and L. Pasteur Hospital, Košice and Gynaecology department, Gynpor, s.r.o., Sliač, Slovakia.

Population and methods:
One hundred and eleven women with stage ≥2 prolapse according to the Pelvic Organe Prolapse – Quantification (POP-Q) system was enrolled into the study. In group MESH A (anterior compartment) was 86 (17x Prolift Anterior; 69x Prolift Anterior like MESH and group MESH P (posterior compartment) was 25 (9x Prolift Posterior; 16x Prolift posterior like MESH) of enrolled women. The primary outcome was the risk of POP ≥2 „de novo“ prolapse in primary unaffected compartment at 12 months follow-up. The second was the efficacy of the treatment by using synhetic mesh. Third was: Did uterus sparing operation increase the risk of reccurance of the prolapse. Complications was also reported.

Results:
For subject attendigs the 12-month follow-up, the risk of „de novo“ prolapse in MESH A group was 20.9% (17/86) compared with only 16% (4/25) in the MESH P group and was not significantly different (p<0.13). The efficacy was 91.6% in the MESH A group and 84% in the MESH P group and was not significantly different. Uterus sparing operation did not increase the risk the prolapse „de novo“ in primary unaffected compartment. Vaginal mesh exposure occured in 14.4%.

Conclusion:
Vaginal repair by using MESH is effective in the treatment of the pelvic organe prolapse, but is posible to provoke the development of prolapse in primary unaffected compartment.

Key words:
pelvic organe prolapse, mesh, retrospective trial.


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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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