Modified Vaginal Mesh Procedure with DynaMesh®-PR4 for the Treatment of Anterior/Apical Vaginal Prolapse

Author:

Lin Chia-Ju1,Liu Chih-Ku1,Hsieh Hsiao-Yun1,Chen Ming-Jer1ORCID,Tsai Ching-Pei123

Affiliation:

1. Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung 40705, Taiwan

2. Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 40204, Taiwan

3. Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 40204, Taiwan

Abstract

(1) Background: Treating female pelvic organ prolapse (POP) is challenging. Surgical meshes have been used in transvaginal surgeries since the 1990s, but complications such as mesh exposure and infection have been reported. Polyvinylidene fluoride (PVDF) mesh, known for its stability and non-reactive properties, has shown promise in urogynecological surgeries. (2) Methods: A retrospective analysis was conducted on 27 patients who underwent a modified PVDF vaginal mesh repair procedure using DynaMesh®-PR4 and combined trans-obturator and sacrospinous fixation techniques. Additional surgeries were performed as needed. (3) Results: The mean operation time was 56.7 min, and the mean blood loss was 66.7 mL. The average hospitalization period was 4.2 days with Foley catheter removal after 2 days. Patients experienced lower pain scores from the day of the operation to the following day. Postoperative follow-up revealed that 85.2% of patients achieved anatomic success, with 14.8% experiencing recurrent stage II cystocele. No recurrence of apical prolapse was observed. Complications were rare, with one case (3.7%) of asymptomatic mesh protrusion. (4) Conclusions: The modified vaginal mesh procedure using DynaMesh®-PR4 showed favorable outcomes with a short operation time, low recurrence rate, rare complications, and improved functional outcomes. This surgical option could be considered for anterior and apical pelvic organ prolapse in women.

Publisher

MDPI AG

Subject

Clinical Biochemistry

Reference31 articles.

1. Symptoms and outcome measures of pelvic organ prolapse;Barber;Clin. Obstet. Gynecol.,2005

2. Sacrocolpopexy for posthysterectomy vaginal vault prolapse: Long-term follow-up;Illiano;Int. Urogynecol. J.,2016

3. (2022, June 13). Urogynecologic Surgical Mesh Update on the Safety and Effectiveness of Transvaginal Placement for Pelvic Organ Prolapse, Available online: https://www.fda.gov/files/medical%20devices/published/Urogynecologic-Surgical-Mesh--Update-on-the-Safety-and-Effectiveness-of-Transvaginal-Placement-for-Pelvic-Organ-Prolapse-%28July-2011%29.pdf.

4. Use of vaginal mesh; an Asian perspective footnote from the pan-Asia meeting;Lo;Int. Urogynecol. J.,2020

5. Anterior Colporrhaphy versus Transvaginal Mesh for Pelvic-Organ Prolapse;Altman;N. Engl. J. Med.,2011

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