New Surgical Procedures for Pelvic Organ Prolapse: Insertion of a Tension-free Vaginal Mesh and Laparoscopic Sacrocolpopexy

Akira Shigeo

doi:10.1272/manms.6.174

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Other Title

メッシュを用いた骨盤臓器脱の新手術　Ｔｅｎｓｉｏｎ　ｆｒｅｅ　ｖａｇｉｎａｌ　ｍｅｓｈ（ＴＶＭ）法と腹腔鏡下腟仙骨固定術
臨床医のためにメッシュを用いた骨盤臓器脱の新手術--Tension free vaginal mesh(TVM)法と腹腔鏡下膣仙骨固定術
リンショウイノタメニメッシュオモチイタコツバンゾウキダツノシンシュジュツ Tension free vaginal mesh TVM ホウトフククウキョウカチツセンコツコテイジュツ

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Abstract

Pelvic organ prolapse is characterized by a lack of pelvic floor support causing the pelvic organs and vaginal wall to protrude. For many decades, suture repair techniques have been the primary choice of surgical treatment when indicated. Traditional surgical techniques are, however, frequently associated with high rate of anatomical recurrence. Since 2004, vaginal mesh surgery with a tension-free vaginal mesh has emerged as an effective method of pelvic floor reconstruction, applicable to most types of pelvic organ prolapse. Gynemesh^®, a thin, highly porous synthetic polypropylene prosthesis, is inserted as a hammock under the bladder, applied laterally on the arcus tendineus fascia pelvis, and retained by 2 nonsecured bilateral transobturator arms. A posterior interrectovaginal prosthesis is inserted in front of the rectum and applied laterally on the levatores ani and is retained by bilateral lateral arms secured to the median part of the sacrospinous ligament. Laparoscopic sacrocolpopexy is another new procedure for the treatment of pelvic organ prolapse. This method is especially suitable for patients younger than 50 years. Because of possible complications, surgeons must learn the technical details of these procedures before performing them and choose the best surgical method according to patient's age, symptoms, and complications.<br>

Journal

Nihon Ika Daigaku Igakkai Zasshi

Nihon Ika Daigaku Igakkai Zasshi 6 (4), 174-177, 2010

The Medical Association of Nippon Medical School

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